Provider Demographics
NPI:1528145570
Name:SCULLY, MARGARET C (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:C
Last Name:SCULLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARET MEGIN
Other - Middle Name:C
Other - Last Name:SCULLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:490 POST STREET
Mailing Address - Street 2:700
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102
Mailing Address - Country:US
Mailing Address - Phone:415-362-2238
Mailing Address - Fax:415-362-7745
Practice Address - Street 1:490 POST STREET
Practice Address - Street 2:700
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102
Practice Address - Country:US
Practice Address - Phone:415-362-2238
Practice Address - Fax:415-362-7745
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62407174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
E89184Medicare UPIN
CA00G624070Medicare ID - Type Unspecified