Provider Demographics
NPI:1649761016
Name:DR. CAREN CAMPBELL, INC.
Entity Type:Organization
Organization Name:DR. CAREN CAMPBELL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-839-8118
Mailing Address - Street 1:450 SUTTER ST RM 2340
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4202
Mailing Address - Country:US
Mailing Address - Phone:415-839-8118
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST RM 2340
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4202
Practice Address - Country:US
Practice Address - Phone:404-276-1580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty