Individual
DAVID MARK NIDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3555 CESAR CHAVEZ, SAN FRANCISCO, CA 94110-4403
(415) 641-6625
Mailing address
384 RIVIERA DR, SAN RAFAEL, CA 94901-1529
(415) 453-5717
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
251090
NY
207P00000X
Emergency Medicine Physician
A49983
CA
207Q00000X
Family Medicine Physician
Primary
A49983
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A499830
—
CA
Enumeration date
06/01/2006
Last updated
11/01/2022
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