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General NPI Number Information
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NPI Number | 1356568984
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Entity Type | Individual
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Provider Name | SONIA BLEDSOE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/13/2015
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Provider Practice Location Address
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Address Line | 121 GOLDEN GATE AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-3809
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Country | US
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Telephone | 415-241-8320
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Fax |
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Provider Business Mailing Address
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Address Line | 150 GOLDEN GATE AVE 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-3810
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Country | US
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Telephone | 415-592-2711
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Fax | 415-440-7776
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | A42140
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A42140
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License Number State | CA
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