Provider Demographics
NPI:1962255067
Name:FALCINELLI, SHANE DAVID (MD)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:DAVID
Last Name:FALCINELLI
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 1:505 PARNASSUS AVENUE
Mailing Address - Street 2:DEPARTMENT OF LABORATORY MEDICINE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:415-926-2167
Mailing Address - Fax:
Practice Address - Street 1:505 PARNASSUS AVENUE
Practice Address - Street 2:DEPARTMENT OF LABORATORY MEDICINE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-926-2167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16206207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine