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NPI Code Detail

MEDICARE: DR. MICHAEL R. BRONZO M.D.

MEDICARE:  DR. MICHAEL R. BRONZO  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
12084P0800XPsychiatry PhysicianG70373CA

General Provider Information

NPI Number : 1972668622
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL R. BRONZO M.D.
Provider Business Mailing Address
First Line : 1700 PIERCE ST STE 401
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-6116
Country : US
Telephone Number : 415-563-3252
Fax Number :
Provider Business Practice Location Address
First Line : 1421 BRODERICK ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-3304
Country : US
Telephone Number : 415-292-1760
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MICHAEL R. BRONZO M.D.” Practice Location

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