Healthcare Provider Details

I. General information

NPI: 1871598706
Provider Name (Legal Business Name): MARY S. GENEVIEVE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY S. AMIR M.D.

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HAYES ST STE 206
SAN FRANCISCO CA
94117-1078
US

IV. Provider business mailing address

2250 HAYES ST STE 206
SAN FRANCISCO CA
94117-1078
US

V. Phone/Fax

Practice location:
  • Phone: 415-379-6100
  • Fax:
Mailing address:
  • Phone: 415-379-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberG84937
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: