Provider Demographics
NPI:1730141573
Name:OSMAN, DEBRA (MD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:OSMAN
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 1:1199 BUSH ST
Mailing Address - Street 2:STE 500
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5976
Mailing Address - Country:US
Mailing Address - Phone:415-674-2600
Mailing Address - Fax:415-674-2601
Practice Address - Street 1:1199 BUSH ST
Practice Address - Street 2:STE 500
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5976
Practice Address - Country:US
Practice Address - Phone:415-674-2600
Practice Address - Fax:415-674-2601
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46339207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110172115OtherPPIN
CAZZZ19216ZOtherMEDICARE PROVIDER ID
CAZZZ19216ZOtherMEDICARE PROVIDER ID
CAZZZ19216ZMedicare ID - Type Unspecified