MEDICARE: CORINNE R MCLEARY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	A81969	CA

General Provider Information

NPI Number	:	1093704603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINNE R MCLEARY MD

Provider Business Mailing Address
First Line	:	2425 GEARY BLVD
Second Line	:	KAISER PERMANENTE, DEPT OF EMERGENCY MEDICINE
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-3358
Country	:	US
Telephone Number	:	415-833-4965
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 GEARY BLVD
Second Line	:	KAISER PERMANENTE, DEPT OF EMERGENCY MEDICINE
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-3358
Country	:	US
Telephone Number	:	415-833-4965
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	01/18/2022

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