Provider Demographics
NPI:1417219114
Name:CAMPBELL, CAREN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAREN
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SUTTER ST RM 2340
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4202
Mailing Address - Country:US
Mailing Address - Phone:415-839-8118
Mailing Address - Fax:415-962-2520
Practice Address - Street 1:450 SUTTER ST RM 2340
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4202
Practice Address - Country:US
Practice Address - Phone:415-217-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-09
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA140728207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology