Provider Demographics
NPI:1144241399
Name:AVRAHAM GIANNINI MD
Entity Type:Organization
Organization Name:AVRAHAM GIANNINI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANNINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-346-8022
Mailing Address - Street 1:909 HYDE ST
Mailing Address - Street 2:STE 633
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4822
Mailing Address - Country:US
Mailing Address - Phone:415-346-8022
Mailing Address - Fax:
Practice Address - Street 1:909 HYDE ST
Practice Address - Street 2:STE 633
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4822
Practice Address - Country:US
Practice Address - Phone:415-346-8022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23685207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A236850Medicaid
CAA23685OtherWORKERS COMP
031912031OtherRAILROAD MEDICARE
CA00A236850OtherBLUE SHIELD
CA00A236850Medicare PIN
CA00A236850Medicaid