Provider Demographics
NPI:1629298690
Name:POWER, KARRON LEGARIE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:KARRON
Middle Name:LEGARIE
Last Name:POWER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:KARRON
Other - Middle Name:RACQUEL
Other - Last Name:LEGARIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:335 FORBES AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901
Mailing Address - Country:US
Mailing Address - Phone:415-577-7038
Mailing Address - Fax:
Practice Address - Street 1:1600 DIVISADERO STREET, BOX 1661
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-771-4472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0667652083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine