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General NPI Number Information
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NPI Number | 1073778213
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Entity Type | Organization
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Legal Business Name | KENNETH F. BINMOELLER, MD INC
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 2333 BUCHANAN ST 5TH FLOOR GI LAB
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-1925
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Country | US
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Telephone | 415-600-1151
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Fax | 415-600-1416
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Provider Business Mailing Address
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Address Line | 3116 W MARCH LN SUITE 200
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City | STOCKTON
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State | CA
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Zip | 95219-2369
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Country | US
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Telephone | 209-473-6555
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Fax | 209-473-6544
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Authorized Official
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Title or Position | CEO
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Name | DR. KENNETH FRANK BINMOELLER
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Credential | M.D
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Telephone | 415-600-1151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A49767
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License Number State | CA
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