Provider Demographics
NPI:1538645940
Name:FIELDS, MICHAEL HARVEY
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HARVEY
Last Name:FIELDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 LARCH WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-4858
Mailing Address - Country:US
Mailing Address - Phone:415-684-5638
Mailing Address - Fax:
Practice Address - Street 1:730 BAKER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-4305
Practice Address - Country:US
Practice Address - Phone:415-567-1498
Practice Address - Fax:415-567-1365
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker