Individual
ELIZABETH MARY MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AG ACNP-BC
Contact information
Practice address
1501 TROUSDALE DR, BURLINGAME, CA 94010-4506
(650) 696-5400
Mailing address
5 PIEDMONT ST APT 2, SAN FRANCISCO, CA 94117-4534
(628) 777-6191
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
NP95009719
CA
Other
Enumeration date
12/11/2018
Last updated
01/04/2019
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