Provider Demographics
NPI:1598051807
Name:JASOLOSKY, ELIZABETH THERESA (DO)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:THERESA
Last Name:JASOLOSKY
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:1 CALIFORNIA ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5424
Mailing Address - Country:US
Mailing Address - Phone:800-997-6196
Mailing Address - Fax:415-504-1367
Practice Address - Street 1:1 CALIFORNIA ST STE 2300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-5424
Practice Address - Country:US
Practice Address - Phone:800-997-6196
Practice Address - Fax:415-504-1367
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2024-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIDO00767207Q00000X
SC83803207Q00000X
MDH84356207Q00000X
NY281255-1207Q00000X
PAOS018981207Q00000X
MI5101023703207Q00000X
MN70859207Q00000X
MO2022006317207Q00000X
MA273844207Q00000X
TXT6602207Q00000X
VA0102203861207Q00000X
IN02005242A207Q00000X
OH34.013114207Q00000X
NC2022-00187207Q00000X
NJ25MB09629500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine