Basic Information
| Provider Information | |||||||||
| NPI: | 1598171035 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LACROIX | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | CREIGHTONM. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 330A GUERRERO ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941033305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7789913442 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 401 PARNASSUS AVE | ||||||||
| Address2: | BOX PLP-0984 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430984 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154767244 | ||||||||
| FaxNumber: | 4154767722 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2014 | ||||||||
| LastUpdateDate: | 07/04/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.