Provider Demographics
NPI:1821146564
Name:DALLMAN, ANN L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:L
Last Name:DALLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:50 LECH WALESA
Mailing Address - Street 2:TOM WADDELL CLINIC
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4506
Mailing Address - Country:US
Mailing Address - Phone:415-355-7471
Mailing Address - Fax:415-355-7408
Practice Address - Street 1:50 LECH WALESA
Practice Address - Street 2:TOM WADDELL CLINIC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4506
Practice Address - Country:US
Practice Address - Phone:415-355-7471
Practice Address - Fax:415-355-7408
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74481207Q00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
047944OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
F85150Medicare UPIN