Healthcare Provider Details

I. General information

NPI: 1467795237
Provider Name (Legal Business Name): RACHAEL HAAS BECKERT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2013
Last Update Date: 12/16/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE M691, BOX 0110
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

263 CLEVELAND AVE
MILL VALLEY CA
94941-3513
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-6245
  • Fax:
Mailing address:
  • Phone: 415-381-4302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: