Provider Demographics
NPI:1174269351
Name:SPANGENBERG, AMELIE (MBBS)
Entity type:Individual
Prefix:DR
First Name:AMELIE
Middle Name:
Last Name:SPANGENBERG
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 DIVISADERO STREET, ROOM 4 20
Mailing Address - Street 2:UCSF, DEPARTMENT OF DERMATOLOGY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115
Mailing Address - Country:US
Mailing Address - Phone:415-353-7880
Mailing Address - Fax:
Practice Address - Street 1:1701 DIVISADERO STREET, ROOM 4 20
Practice Address - Street 2:UCSF, DEPARTMENT OF DERMATOLOGY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-353-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2025-06-30
Deactivation Date:2023-03-20
Deactivation Code:
Reactivation Date:2023-03-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program