MEDICARE: DR. ANNE IRENE THORSON 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	207RC0000X	Cardiovascular Disease Physician	G57740	CA

General Provider Information

NPI Number	:	1861567604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE IRENE THORSON MD

Provider Business Mailing Address
First Line	:	505 PARNASSUS AVENUE
Second Line	:	M314
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-0214
Country	:	US
Telephone Number	:	415-353-1744
Fax Number	:	415-353-8687

Provider Business Practice Location Address
First Line	:	505 PARNASSUS AVENUE
Second Line	:	M314
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-0214
Country	:	US
Telephone Number	:	415-353-1744
Fax Number	:	415-353-8687

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	07/08/2007

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