Healthcare Provider Details

I. General information

NPI: 1104647965
Provider Name (Legal Business Name): ELIZABETH MADELEINE EDWINA COLE MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVENUE DEPARTMENT OF ANESTHESIA AT UCSF
SAN FRANCSICO CA
94143-2204
US

IV. Provider business mailing address

4637 17TH ST
SAN FRANCISCO CA
94117-4412
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number853
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: