Provider Demographics
NPI:1003201237
Name:CONGDON, JAYME (MD)
Entity type:Individual
Prefix:
First Name:JAYME
Middle Name:
Last Name:CONGDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:
Other - Last Name:MULKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3333 CALIFORNIA ST STE 245
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-6210
Mailing Address - Country:US
Mailing Address - Phone:415-476-8273
Mailing Address - Fax:415-476-6106
Practice Address - Street 1:1500 OWENS ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158
Practice Address - Country:US
Practice Address - Phone:415-476-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143766208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics