Provider Demographics
NPI:1255468245
Name:BAMBERGER, JOSHUA D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:D
Last Name:BAMBERGER
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 1:234 EDDY ST
Mailing Address - Street 2:HOUSING AND URBAN HEALTH CLINIC
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-2716
Mailing Address - Country:US
Mailing Address - Phone:415-353-5095
Mailing Address - Fax:415-292-5048
Practice Address - Street 1:234 EDDY ST
Practice Address - Street 2:HOUSING AND URBAN HEALTH CLINIC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2716
Practice Address - Country:US
Practice Address - Phone:415-353-5095
Practice Address - Fax:415-292-5048
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70403207Q00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
049692OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
049692OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER