Individual
DR. JENNIFER M. PUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1825 FOUTH STREET, 6TH FLOOR, IMMUNOLOGY CENTER, SAN FRANCISCO, CA 94158
(415) 502-2090
(415) 502-2107
Mailing address
550 16TH ST, BOX 0434, SAN FRANCISCO, CA 94143
(415) 502-2090
(415) 502-2107
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G87720
CA
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
G87720
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G877200
—
CA
Enumeration date
07/07/2006
Last updated
06/05/2015
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