Provider Demographics
NPI:1134145550
Name:ZANELLI, GAETANO (MD)
Entity Type:Individual
Prefix:DR
First Name:GAETANO
Middle Name:
Last Name:ZANELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WEBSTER ST STE 416
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2379
Mailing Address - Country:US
Mailing Address - Phone:415-923-3600
Mailing Address - Fax:415-923-3605
Practice Address - Street 1:2100 WEBSTER ST 416
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2379
Practice Address - Country:US
Practice Address - Phone:415-923-3600
Practice Address - Fax:415-923-3605
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG071906207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF 74821Medicare UPIN
CA00G719060Medicare ID - Type Unspecified