Provider Demographics
NPI:1992921084
Name:ARMBRUST, JILL LARALYN (MD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:LARALYN
Last Name:ARMBRUST
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 1:709 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1614
Mailing Address - Country:US
Mailing Address - Phone:415-441-2976
Mailing Address - Fax:415-673-7854
Practice Address - Street 1:709 SCOTT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1614
Practice Address - Country:US
Practice Address - Phone:415-673-2576
Practice Address - Fax:415-673-7854
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39554174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist