Healthcare Provider Details

I. General information

NPI: 1942015151
Provider Name (Legal Business Name): KEVIN DANIS LI MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

480 WARREN DR APT 432
SAN FRANCISCO CA
94131-1096
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2200
  • Fax:
Mailing address:
  • Phone: 408-368-9825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number18263
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: