Provider Demographics
NPI:1902099807
Name:SHOLARS, HENRIETTA B (DO)
Entity type:Individual
Prefix:
First Name:HENRIETTA
Middle Name:B
Last Name:SHOLARS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:HENNIE
Other - Middle Name:
Other - Last Name:SHOLARS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:29 29TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4910
Mailing Address - Country:US
Mailing Address - Phone:415-401-1630
Mailing Address - Fax:415-401-8330
Practice Address - Street 1:29 29TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4910
Practice Address - Country:US
Practice Address - Phone:415-401-1630
Practice Address - Fax:415-401-8330
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB58263OtherUPIN