Individual
DR. MARY KARIN CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 DIVISADERO ST, SAN FRANCISCO, CA 94115-3011
(415) 353-7800
(415) 353-9654
Mailing address
1635 DIVISADERO STREET, SUITE 625, BOX 1821, SAN FRANCISCO, CA 94143-0001
(415) 476-4029
(415) 476-4150
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G57864
CA
207R00000X
Internal Medicine Physician
G57864
CA
207RR0500X
Rheumatology Physician
G57864
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0G5786400
—
CA
Enumeration date
04/17/2006
Last updated
08/28/2012
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