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General NPI Number Information
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NPI Number | 1215083035
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Entity Type | Organization
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Legal Business Name | RICHARD R. TAVERNETTI, M.D., INC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 2100 WEBSTER ST SUITE 115
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-2373
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Country | US
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Telephone | 415-923-3033
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Fax | 415-923-3083
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Provider Business Mailing Address
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Address Line | 2100 WEBSTER ST SUITE 115
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-2373
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Country | US
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Telephone | 415-923-3033
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Fax | 415-923-3083
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD ROLAND TAVERNETTI
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Credential | M.D.
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Telephone | 415-923-3033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | A23135
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License Number State | CA
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