Provider Demographics
NPI:1578887311
Name:MATHER, CHERYL ALYSSA (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ALYSSA
Last Name:MATHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:185 BERRY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-5705
Mailing Address - Country:US
Mailing Address - Phone:415-514-8214
Mailing Address - Fax:
Practice Address - Street 1:185 BERRY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-5705
Practice Address - Country:US
Practice Address - Phone:415-514-8214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60295984207ZP0102X
CAA137058207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology