Provider Demographics
NPI:1427279819
Name:AGBAI, NATASHA (MD)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:AGBAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MESA ST STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94129-1157
Mailing Address - Country:US
Mailing Address - Phone:415-797-4008
Mailing Address - Fax:415-406-6842
Practice Address - Street 1:40 MESA ST STE 114
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94129-1157
Practice Address - Country:US
Practice Address - Phone:415-797-4008
Practice Address - Fax:415-406-6842
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA96945208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics