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General NPI Number Information
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NPI Number | 1396842001
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Entity Type | Individual
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Provider Name | LAURA MICHELLE GOTTLIEB MD, MPH
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Gender | Female
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 3333 CALIFORNIA ST SUITE 465, BOX0844
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1981
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Country | US
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Telephone | 415-509-8976
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 CALIFORNIA STREET, SUITE 465, BOX 0844
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0844
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Country | US
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Telephone | 415-509-8976
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD20060465
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C54363
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License Number State | CA
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