Healthcare Provider Details

I. General information

NPI: 1629298690
Provider Name (Legal Business Name): KARRON LEGARIE POWER M.D., M.P.H
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARRON RACQUEL LEGARIE M.D., M.P.H

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 DIVISADERO STREET, BOX 1661
SAN FRANCISCO CA
94115
US

IV. Provider business mailing address

206 BON AIR CTR
GREENBRAE CA
94904-2416
US

V. Phone/Fax

Practice location:
  • Phone: 415-771-4472
  • Fax:
Mailing address:
  • Phone: 415-785-7995
  • Fax: 415-419-5890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberA066765
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: