1699825521 NPI number — MOUNT ST. JOSEPH-ST. ELIZABETH

Table of content: DORIAN YELENA APONTE MD (NPI 1144424557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699825521 NPI number — MOUNT ST. JOSEPH-ST. ELIZABETH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUNT ST. JOSEPH-ST. ELIZABETH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699825521
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MASONIC AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94118-4415
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-351-4054
Provider Business Mailing Address Fax Number:
415-292-5531

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 MASONIC AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94118-4415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-351-4054
Provider Business Practice Location Address Fax Number:
415-292-5531
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DUNKEL
Authorized Official First Name:
SISTER BETTY
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
415-351-4045

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  380081CN , 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)





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