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General NPI Number Information
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NPI Number | 1063449759
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Entity Type | Individual
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Provider Name | KEVIN AKIRA FUKUDA MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1783 EL CAMINO REAL
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City | BURLINGAME
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State | CA
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Zip | 94010-3205
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Country | US
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Telephone | 650-696-5400
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Fax | 650-696-5208
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Provider Business Mailing Address
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Address Line | PO BOX 7793
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City | SAN FRANCISCO
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State | CA
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Zip | 94120-7793
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G81100
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License Number State | CA
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