Doctor Name: | DR. AUDREY DENISE SELLERS |
NPI Number: | 1942346242 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | G62874 |
Business Practice Address: | 1111 Market St First Floor San Francisco, CA - 941031513 |
Business Phone Number: | 4158633883 |
Business Fax Number: | 4158637343 |
Mailing Address: | 1111 Market St, First Floor SAN FRANCISCO |
State: | CA |
Postal Code: | 941031513 |
Phone Number: | 4158633883 |
Fax Number: | 4158637343 |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G62874 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |