Basic Information
| Provider Information | |||||||||
| NPI: | 1497175798 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KEENAN | ||||||||
| FirstName: | BRIDGET | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 PARNASSUS AVE | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154761528 | ||||||||
| FaxNumber: | 4155021976 | ||||||||
| Practice Location | |||||||||
| Address1: | 505 PARNASSUS AVE | ||||||||
| Address2: | RM. 987 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154761528 | ||||||||
| FaxNumber: | 4155021976 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2014 | ||||||||
| LastUpdateDate: | 10/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | A145542 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.