Provider Demographics
NPI:1831625821
Name:BRAVEMAN, PAULA ANNE (MD, MPH)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ANNE
Last Name:BRAVEMAN
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 1:25 HILL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2312
Mailing Address - Country:US
Mailing Address - Phone:415-824-0179
Mailing Address - Fax:415-476-5219
Practice Address - Street 1:25 HILL ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2312
Practice Address - Country:US
Practice Address - Phone:415-824-0179
Practice Address - Fax:415-476-5219
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine