Provider Demographics
NPI:1609048107
Name:MICHAEL SHILOH
Entity Type:Organization
Organization Name:MICHAEL SHILOH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INFECTIOUS DISEASE SPECIALIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHILOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:415-564-6764
Mailing Address - Street 1:1263 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-1238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1263 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-1238
Practice Address - Country:US
Practice Address - Phone:415-564-6764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82262207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609048107OtherTYPE 1 NPI
1609048107OtherTYPE 1 NPI