Provider Demographics
NPI:1487663019
Name:DORSEY, MORNA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MORNA
Middle Name:JEAN
Last Name:DORSEY
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 1:550 16TH STREET, BOX 0434
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:415-476-3086
Mailing Address - Fax:415-502-2107
Practice Address - Street 1:1825 FOURTH STREET, 6TH FLOOR
Practice Address - Street 2:IMMUNOLOGY CENTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158
Practice Address - Country:US
Practice Address - Phone:415-476-3086
Practice Address - Fax:415-502-2107
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93818208000000X, 2080P0201X, 207KA0200X
CAC558272080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28724OtherBLUE CROSS BLUE SHIELD
FL273410900Medicaid
FL28724OtherBLUE CROSS BLUE SHIELD
FL28724ZMedicare PIN