Provider Demographics
NPI:1710014709
Name:MARIE-ROSE, PIERRE-JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:PIERRE-JOSEPH
Middle Name:
Last Name:MARIE-ROSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE
Mailing Address - Street 2:MAIL STOP 6E
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-8361
Mailing Address - Fax:415-206-3686
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:MAIL STOP 6E
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8361
Practice Address - Fax:415-206-3686
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG727682080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
022863OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
022863OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER