Provider Demographics
NPI:1992725139
Name:PURCELL, DORIS S (MD)
Entity type:Individual
Prefix:DR
First Name:DORIS
Middle Name:S
Last Name:PURCELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:DORIS
Other - Middle Name:S
Other - Last Name:VANDERPOOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:580 CALIFORNIA ST
Mailing Address - Street 2:SUITE 1750
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-1000
Mailing Address - Country:US
Mailing Address - Phone:415-402-0266
Mailing Address - Fax:415-402-0299
Practice Address - Street 1:580 CALIFORNIA ST
Practice Address - Street 2:SUITE 1750
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-1000
Practice Address - Country:US
Practice Address - Phone:415-402-0266
Practice Address - Fax:415-402-0299
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72785207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH47342Medicare UPIN