Provider Demographics
NPI:1851465173
Name:VANLANDINGHAM, REBECCA G (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:G
Last Name:VANLANDINGHAM
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:100 PINE ST
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5102
Mailing Address - Country:US
Mailing Address - Phone:415-499-9991
Mailing Address - Fax:415-276-1995
Practice Address - Street 1:166 GEARY ST
Practice Address - Street 2:SUITE 1102
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-5631
Practice Address - Country:US
Practice Address - Phone:415-499-9991
Practice Address - Fax:415-276-1995
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2014-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA83451207K00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A834510Medicaid
CA00A834510Medicaid
00A834510Medicare ID - Type Unspecified