Basic Information
Provider Information
NPI: 1740288901
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASHLEY
FirstName: PHOEBE
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 505 PARNASSUS AVE # 124
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941432204
CountryCode: US
TelephoneNumber: 8043586100
FaxNumber: 8043427619
Practice Location
Address1: 535 MISSION BAY BLVD S
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941432156
CountryCode: US
TelephoneNumber: 4153532873
FaxNumber: 4153532528
Other Information
ProviderEnumerationDate: 07/12/2005
LastUpdateDate: 08/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XC180793CAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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