Basic Information
| Provider Information | |||||||||
| NPI: | 1487663019 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DORSEY | ||||||||
| FirstName: | MORNA | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 16TH STREET, BOX 0434 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154763086 | ||||||||
| FaxNumber: | 4155022107 | ||||||||
| Practice Location | |||||||||
| Address1: | 1825 FOURTH STREET, 6TH FLOOR | ||||||||
| Address2: | IMMUNOLOGY CENTER | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154763086 | ||||||||
| FaxNumber: | 4155022107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 05/20/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME93818 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0201X | ME93818 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Allergy/Immunology | 207KA0200X | ME93818 | FL | N | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | 2080P0201X | C55827 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Allergy/Immunology |
ID Information
| ID | Type | State | Issuer | Description | 28724 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER | 273410900 | 05 | FL | MEDICAID |