Healthcare Provider Details

I. General information

NPI: 1205009115
Provider Name (Legal Business Name): JEFFREY MARC GELFAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE M-798 UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
SAN FRANCISCO CA
94143-0114
US

IV. Provider business mailing address

505 PARNASSUS AVE M-798 BOX 0114 UNIVERSITY OF CALIFORNIA SAN FRANCISCO
SAN FRANCISCO CA
94143-0114
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1489
  • Fax:
Mailing address:
  • Phone: 415-476-1489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA103287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: