Provider Demographics
NPI:1285826891
Name:ROSANELLI, THOMAS SIMONE (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:SIMONE
Last Name:ROSANELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-2807
Mailing Address - Country:US
Mailing Address - Phone:415-931-9881
Mailing Address - Fax:
Practice Address - Street 1:1954 LOMBARD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-2807
Practice Address - Country:US
Practice Address - Phone:415-931-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5246208600000X
CAA35622208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery