Provider Demographics
NPI:1285826891
Name:ROSANELLI, THOMAS SIMONE (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:SIMONE
Last Name:ROSANELLI
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 1:2000 VAN NESS AVE
Mailing Address - Street 2:SUITE #209
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3023
Mailing Address - Country:US
Mailing Address - Phone:415-931-9881
Mailing Address - Fax:415-931-1045
Practice Address - Street 1:2000 VAN NESS AVE
Practice Address - Street 2:SUITE #209
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3023
Practice Address - Country:US
Practice Address - Phone:415-931-9881
Practice Address - Fax:415-931-1045
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA35622208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery