Provider Demographics
NPI:1831425107
Name:CHODOS, ANNA HASELTINE (MD, MPH)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:HASELTINE
Last Name:CHODOS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE
Mailing Address - Street 2:BOX 1364
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-1364
Mailing Address - Country:US
Mailing Address - Phone:415-206-4852
Mailing Address - Fax:
Practice Address - Street 1:519 LINCOLN WAY
Practice Address - Street 2:APT 4
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2569
Practice Address - Country:US
Practice Address - Phone:415-206-5164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112399207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine