Provider Demographics
NPI:1790264422
Name:MCMURDO, SHALINI
Entity Type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:MCMURDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2717
Mailing Address - Country:US
Mailing Address - Phone:415-608-6122
Mailing Address - Fax:
Practice Address - Street 1:1486 HUNTINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5971
Practice Address - Country:US
Practice Address - Phone:415-608-6122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program