Healthcare Provider Details

I. General information

NPI: 1720323991
Provider Name (Legal Business Name): KRISTIN L PAPPAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BON AIR RD
GREENBRAE CA
94904-1702
US

IV. Provider business mailing address

420 BAKER ST APT 4
SAN FRANCISCO CA
94117-1427
US

V. Phone/Fax

Practice location:
  • Phone: 415-925-7100
  • Fax:
Mailing address:
  • Phone: 503-709-2761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberA129317
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number129317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: