Provider Demographics
NPI:1487759007
Name:OBERSCHELP, ALISA GRACE (MD)
Entity type:Individual
Prefix:DR
First Name:ALISA
Middle Name:GRACE
Last Name:OBERSCHELP
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 1:50 LECH WALESA
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4506
Mailing Address - Country:US
Mailing Address - Phone:415-355-7474
Mailing Address - Fax:415-355-7407
Practice Address - Street 1:50 LECH WALESA
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4506
Practice Address - Country:US
Practice Address - Phone:415-355-7474
Practice Address - Fax:415-355-7407
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGO77937207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine