Provider Demographics
NPI:1447459185
Name:O'MALLEY, ANNA KRISTINA (MD)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:KRISTINA
Last Name:O'MALLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MIRAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3675
Mailing Address - Country:US
Mailing Address - Phone:415-847-4720
Mailing Address - Fax:
Practice Address - Street 1:3419 STATE ROUTE 1
Practice Address - Street 2:
Practice Address - City:STINSON BEACH
Practice Address - State:CA
Practice Address - Zip Code:94970
Practice Address - Country:US
Practice Address - Phone:415-663-8781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100464207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine