Healthcare Provider Details

I. General information

NPI: 1497818751
Provider Name (Legal Business Name): WARREN D KRONENBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 CORTLAND AVE
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

1275 ARGUELLO BLVD
SAN FRANCISCO CA
94122
US

V. Phone/Fax

Practice location:
  • Phone: 415-550-1881
  • Fax: 415-550-1791
Mailing address:
  • Phone: 415-753-2624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC42172
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: