Provider Demographics
NPI:1275692873
Name:PRIETO, VICTOR ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ANTHONY
Last Name:PRIETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 HYDE ST
Mailing Address - Street 2:11TH FLOOR ST FRANCIS HOSP
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109
Mailing Address - Country:US
Mailing Address - Phone:415-353-6400
Mailing Address - Fax:415-353-6401
Practice Address - Street 1:900 HYDE ST
Practice Address - Street 2:11TH FLOOR ST FRANCIS HOSP
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109
Practice Address - Country:US
Practice Address - Phone:415-353-6400
Practice Address - Fax:415-353-6401
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43097207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A49226Medicare UPIN
00G430970Medicare ID - Type Unspecified