Provider Demographics
NPI:1750313383
Name:DEUTSCH, MADELINE B (MD)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:B
Last Name:DEUTSCH
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 1:2261 MARKET ST
Mailing Address - Street 2:#612
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114
Mailing Address - Country:US
Mailing Address - Phone:415-373-9330
Mailing Address - Fax:323-679-0389
Practice Address - Street 1:450 STANYAN ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117
Practice Address - Country:US
Practice Address - Phone:415-373-9330
Practice Address - Fax:323-679-0389
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80419207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A804190Medicaid
CAWA80419AMedicare PIN
CAWA80419EMedicare PIN
CA00A804190Medicare PIN
CA00A804190Medicaid
CAWA80419FMedicare PIN
CAWA80419BMedicare PIN