Healthcare Provider Details

I. General information

NPI: 1871817536
Provider Name (Legal Business Name): KARIN KERK M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CIVIC CENTER DR STE 206
SAN RAFAEL CA
94903-5233
US

IV. Provider business mailing address

4000 CIVIC CENTER DR STE 206
SAN RAFAEL CA
94903-5233
US

V. Phone/Fax

Practice location:
  • Phone: 415-925-8895
  • Fax: 415-464-5470
Mailing address:
  • Phone: 415-925-8895
  • Fax: 415-464-5470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA108988
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: