MEDICARE: NOAH CARRAHER

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	174400000X	Specialist

General Provider Information

NPI Number	:	1710342910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH CARRAHER

Provider Business Mailing Address
First Line	:	101 NEW MONTGOMERY ST
Second Line	:	4TH FLOOR
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94105-3623
Country	:	US
Telephone Number	:	415-417-5645
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 NEW MONTGOMERY ST
Second Line	:	4TH FLOOR
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94105-3623
Country	:	US
Telephone Number	:	415-417-5645
Fax Number	:

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

Provider Enumeration Date	:	12/15/2015
Last Update Date	:	12/15/2015

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Directions to “ NOAH CARRAHER ” Practice Location

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