Healthcare Provider Details

I. General information

NPI: 1629149331
Provider Name (Legal Business Name): MARILYN M ROBERTSON MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HAYES ST STE 612
SAN FRANCISCO CA
94117-1078
US

IV. Provider business mailing address

PO BOX 590549
SAN FRANCISCO CA
94159-0549
US

V. Phone/Fax

Practice location:
  • Phone: 415-268-3208
  • Fax: 415-621-2947
Mailing address:
  • Phone: 415-268-3208
  • Fax: 415-621-2947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG69580
License Number StateCA

VIII. Authorized Official

Name: DR. MARILYN M ROBERTSON
Title or Position: NEUROLOGIST
Credential: M.D.
Phone: 415-268-3208