Healthcare Provider Details

I. General information

NPI: 1083824288
Provider Name (Legal Business Name): KIRK TRUMAN METZGER R.R.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4624 18TH ST
SAN FRANCISCO CA
94114-1834
US

IV. Provider business mailing address

4624 18TH ST
SAN FRANCISCO CA
94114-1834
US

V. Phone/Fax

Practice location:
  • Phone: 415-864-1912
  • Fax:
Mailing address:
  • Phone: 415-864-1912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number18588
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: