MEDICARE: VERA LIFE

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	207SG0203X	Clinical Molecular Genetics Physician

General Provider Information

NPI Number	:	1497428049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERA LIFE

Provider Business Mailing Address
First Line	:	1515 PINE ST APT 3
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-4643
Country	:	US
Telephone Number	:	415-931-2517
Fax Number	:

Provider Business Practice Location Address
First Line	:	2151 BERKELEY WAY
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94720-2502
Country	:	US
Telephone Number	:	510-664-9073
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER AND CEO
Name	:	MICHAEL JAMES COFFEY
Credential	:
Telephone Number	:	415-931-2517

Provider Enumeration Date	:	07/29/2021
Last Update Date	:	07/29/2021

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Directions to “VERA LIFE ” Practice Location

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