Healthcare Provider Details

I. General information

NPI: 1093032567
Provider Name (Legal Business Name): RISHA LI MOSKALEWICZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

22 DELMAR ST
SAN FRANCISCO CA
94117-4006
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-6245
  • Fax: 415-276-1757
Mailing address:
  • Phone: 415-407-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberA119481
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: