1083884480 NPI number — SARAH BENTLEY WILSON HANNAY M.D.

Table of content: SARAH BENTLEY WILSON HANNAY M.D. (NPI 1083884480)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083884480 NPI number — SARAH BENTLEY WILSON HANNAY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILSON HANNAY
Provider First Name:
SARAH
Provider Middle Name:
BENTLEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WILSON
Provider Other First Name:
SARAH
Provider Other Middle Name:
BENTLEY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1083884480
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18 MANDANA CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94610-2433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-987-3324
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 POTRERO AVE # 6D
Provider Second Line Business Practice Location Address:
SFGH OBGYN
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94110-3518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-206-3061
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/03/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  A102909 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)