Provider Demographics
NPI:1700896560
Name:ELVEBAKK, RANVEIG N (MD)
Entity Type:Individual
Prefix:
First Name:RANVEIG
Middle Name:N
Last Name:ELVEBAKK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:450 SUTTER ST
Mailing Address - Street 2:SUITE 1325
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4206
Mailing Address - Country:US
Mailing Address - Phone:415-989-1007
Mailing Address - Fax:415-989-1804
Practice Address - Street 1:450 SUTTER ST
Practice Address - Street 2:SUITE 1325
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4206
Practice Address - Country:US
Practice Address - Phone:415-989-1007
Practice Address - Fax:415-989-1804
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2012-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA43379207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF76907Medicare UPIN
CA00A433790Medicare PIN