Provider Demographics
NPI: | 1497985683 |
---|---|
Name: | VENADO ESTRADA, AIDA ADRIANA (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | AIDA |
Middle Name: | ADRIANA |
Last Name: | VENADO ESTRADA |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | AIDA |
Other - Middle Name: | |
Other - Last Name: | VENADO |
Other - Suffix: | |
Other - Last Name Type: | Professional Name |
Other - Credentials: | MD |
Mailing Address - Street 1: | 350 PARNASSUS AVE STE 305 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN FRANCISCO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94117-3608 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 400 PARNASSUS AVE FL 5 |
Practice Address - Street 2: | |
Practice Address - City: | SAN FRANCISCO |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94143 |
Practice Address - Country: | US |
Practice Address - Phone: | 415-353-2577 |
Practice Address - Fax: | 415-353-8944 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2009-07-22 |
Last Update Date: | 2018-07-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A137303 | 207R00000X, 207RP1001X, 207RC0200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |