Healthcare Provider Details

I. General information

NPI: 1093437709
Provider Name (Legal Business Name): MARIAM WARE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIAM WARE

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 9TH ST
SAN FRANCISCO CA
94103-2603
US

IV. Provider business mailing address

120 PAGE ST
SAN FRANCISCO CA
94102
US

V. Phone/Fax

Practice location:
  • Phone: 415-255-6544
  • Fax:
Mailing address:
  • Phone: 415-255-6544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: