Provider Demographics
NPI:1548302102
Name:MCNAMARA, MARGARET MARY (M D)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARY
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-8361
Mailing Address - Fax:415-206-3686
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-8361
Practice Address - Fax:415-206-3686
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74142208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG74142OtherCA MEDICAL LICENSE
CA00G741120Medicaid
CAF68667Medicare UPIN
CA00G7411420Medicare ID - Type Unspecified