Healthcare Provider Details

I. General information

NPI: 1467584490
Provider Name (Legal Business Name): ELIZABETH KANTOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 TURK ST NO OF MARKET SR. SVCS - CURRY SR. CENTER
SAN FRANCISCO CA
94102-3703
US

IV. Provider business mailing address

333 TURK ST NO OF MARKET SR. SVCS - CURRY SR. CENTER
SAN FRANCISCO CA
94102-3703
US

V. Phone/Fax

Practice location:
  • Phone: 415-885-2274
  • Fax: 415-885-2344
Mailing address:
  • Phone: 415-885-2274
  • Fax: 415-885-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberG38590
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberG38590
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberG38590
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: