Healthcare Provider Details

I. General information

NPI: 1154409761
Provider Name (Legal Business Name): STEFAN DAN ARNON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 BROADWAY ST APT 804
SAN FRANCISCO CA
94115
US

IV. Provider business mailing address

2090 BROADWAY ST APT 804
SAN FRANCISCO CA
94115-1510
US

V. Phone/Fax

Practice location:
  • Phone: 415-309-4804
  • Fax: 415-829-3626
Mailing address:
  • Phone: 415-866-4027
  • Fax: 415-829-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG15154
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: