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General NPI Number Information
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NPI Number | 1568040350
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Entity Type | Individual
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Provider Name | EL SHADDAI TESFAYE MD
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Gender | Female
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Dates
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Enumeration Date | 04/01/2021
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 2041 GEORGIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20060-0001
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Country | US
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Telephone | 214-536-0270
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Fax |
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Provider Business Mailing Address
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Address Line | 1 EMBARCADERO CTR STE 1900
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-3723
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Country | US
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Telephone | 415-658-6791
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Fax | 415-252-7176
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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 | MD500003464
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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