Healthcare Provider Details

I. General information

NPI: 1285865758
Provider Name (Legal Business Name): BITTOO KANWAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2009
Last Update Date: 08/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PARNASSUS AVE MU4E
SAN FRANCISCO CA
94143-0136
US

IV. Provider business mailing address

500 PARNASSUS AVE MU4E
SAN FRANCISCO CA
94143-0136
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-5892
  • Fax: 415-476-1343
Mailing address:
  • Phone: 415-476-5892
  • Fax: 415-476-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberA92089
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: