Provider Demographics
NPI:1619022233
Name:DAMES, SEVASTI (MD)
Entity Type:Individual
Prefix:
First Name:SEVASTI
Middle Name:
Last Name:DAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 GOUGH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5920
Mailing Address - Country:US
Mailing Address - Phone:415-230-5489
Mailing Address - Fax:415-291-0489
Practice Address - Street 1:98 GOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5920
Practice Address - Country:US
Practice Address - Phone:415-230-5489
Practice Address - Fax:415-291-0489
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63040207R00000X, 208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE25139Medicare UPIN