MEDICARE: DR. LAUREN STANDIG M.D.

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	207R00000X	Internal Medicine Physician	G71965	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619950698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN STANDIG M.D.

Provider Business Mailing Address
First Line	:	300 EUREKA ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94114-2713
Country	:	US
Telephone Number	:	415-641-4027
Fax Number	:	415-285-3707

Provider Business Practice Location Address
First Line	:	1580 VALENCIA ST
Second Line	:	SUITE 809
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-4423
Country	:	US
Telephone Number	:	415-641-4027
Fax Number	:

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	12/08/2010

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