Individual
CAROLINA ELLINGER DA FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1975 4TH ST, SAN FRANCISCO, CA 94143-2351
(415) 514-4079
Mailing address
22201 MOROSS RD STE 80, DETROIT, MI 48236-2169
(313) 343-3800
(313) 343-4756
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4351047788
MI
208000000X
Pediatrics Physician
Primary
A196003
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2021
Last updated
08/05/2025
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