Basic Information
Provider Information
NPI: 1740625201
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DILLON
FirstName: CHRISTY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 391 HAIGHT ST
Address2: APT 4
City: SAN FRANCISCO
State: CA
PostalCode: 941026148
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 450 STANYAN ST
Address2: ST. MARY'S MEDICAL CENTER INTERNAL MEDICINE RESIDENCY
City: SAN FRANCISCO
State: CA
PostalCode: 941171019
CountryCode: US
TelephoneNumber: 4156681000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/09/2013
LastUpdateDate: 12/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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