MEDICARE: STUART M PICKEL MD A PROFESSIONAL CORPORATION

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	2084P0800X	Psychiatry Physician	C32405	CA
2	2084F0202X	Forensic Psychiatry Physician	C32405	CA

General Provider Information

NPI Number	:	1366590838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STUART M PICKEL MD A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	909 HYDE STREET
Second Line	:	SUITE 425
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-4846
Country	:	US
Telephone Number	:	415-928-3277
Fax Number	:	415-928-0408

Provider Business Practice Location Address
First Line	:	909 HYDE STREET
Second Line	:	SUITE 425
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-4846
Country	:	US
Telephone Number	:	415-928-3277
Fax Number	:	415-928-0408

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STUART MICHAEL PICKEL
Credential	:	MD
Telephone Number	:	415-928-3277

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	09/11/2025

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