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General NPI Number Information
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NPI Number | 1518473651
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Entity Type | Individual
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Provider Name | JONATHAN DAVID ROOT MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2017
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Last Update Date | 12/27/2017
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Provider Practice Location Address
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Address Line | 37 W CLAY ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-1230
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Country | US
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Telephone | 650-521-7471
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Fax | 650-234-7701
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Provider Business Mailing Address
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Address Line | 37 W CLAY ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-1230
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Country | US
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Telephone | 650-521-7471
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Fax | 650-234-7701
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | G83586
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License Number State | CA
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