Basic Information
| Provider Information | |||||||||
| NPI: | 1700207990 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAYS | ||||||||
| FirstName: | DWAN | ||||||||
| MiddleName: | TONITA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 BRANNAN ST STE 401 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941034888 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4158644655 | ||||||||
| FaxNumber: | 4156262398 | ||||||||
| Practice Location | |||||||||
| Address1: | 730 BAKER ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155671498 | ||||||||
| FaxNumber: | 4155671365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2013 | ||||||||
| LastUpdateDate: | 10/08/2018 | ||||||||
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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 | 172V00000X | Y | Other Service Providers | Community Health Worker |
No ID Information.