Provider Demographics
NPI:1427124098
Name:ALHADHRAMI, GABULL MOHAMED (NP)
Entity type:Individual
Prefix:
First Name:GABULL
Middle Name:MOHAMED
Last Name:ALHADHRAMI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:GABULL
Other - Middle Name:MOHAMED
Other - Last Name:ABDULLAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:350 SAINT JOSEPHS AVE
Mailing Address - Street 2:BASEMENT
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3255
Mailing Address - Country:US
Mailing Address - Phone:209-406-4004
Mailing Address - Fax:
Practice Address - Street 1:2200 OFARRELL ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3357
Practice Address - Country:US
Practice Address - Phone:209-557-6975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA498021163WD0400X
CA11057363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP33689Medicare UPIN