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General NPI Number Information
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NPI Number | 1356924831
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Entity Type | Individual
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Provider Name | BLAKE KINSEL DO
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Gender | Male
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 09/22/2024
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Provider Practice Location Address
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Address Line | 1600 OWENS ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94158-2261
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Country | US
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Telephone | 415-833-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 181 BARTLETT ST APT 5
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-3060
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Country | US
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Telephone | 419-961-6746
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.017089
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23045
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License Number State | CA
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