Healthcare Provider Details

I. General information

NPI: 1265470520
Provider Name (Legal Business Name): DAVID R. PRIEST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 STANYAN ST DEPARTMENT OF RADIOLOGY
SAN FRANCISCO CA
94117-1079
US

IV. Provider business mailing address

275 BURNETT AVE #8
SAN FRANCISCO CA
94143-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1668
  • Fax: 415-750-4853
Mailing address:
  • Phone: 415-750-5770
  • Fax: 415-750-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberA71466
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberME84280
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME84280
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA71466
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: