Provider Demographics
NPI:1669595989
Name:AMODEO, MICHAEL V (NP)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:V
Last Name:AMODEO
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:1001 POTRERO AVE FL BLDG.9-2ND
Mailing Address - Street 2:SFGH - OCCUPATIONAL HEALTH SERVICE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-8401
Mailing Address - Fax:415-206-3669
Practice Address - Street 1:1001 POTRERO AVE FL BLDG.9-2ND
Practice Address - Street 2:SFGH - OCCUPATIONAL HEALTH SERVICE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8401
Practice Address - Fax:415-206-3669
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANPF106072083X0100X
CARN3977732083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
069237OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
069237OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER