Provider Demographics
NPI:1114189784
Name:LESTER, TIFFANY RACHEL (MD)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:RACHEL
Last Name:LESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:RACHEL
Other - Last Name:LESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:600 CALIFORNIA ST FL 11
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-2727
Mailing Address - Country:US
Mailing Address - Phone:415-515-9382
Mailing Address - Fax:
Practice Address - Street 1:600 CALIFORNIA ST FL 11
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-2727
Practice Address - Country:US
Practice Address - Phone:415-515-9382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144887261QP2300X
OH35.095368207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care