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General NPI Number Information
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NPI Number | 1467497057
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Entity Type | Individual
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Provider Name | ALBERT KADOSH D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 450 SUTTER ST RM 2040
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4109
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Country | US
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Telephone | 415-398-8555
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Fax | 415-398-1058
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Provider Business Mailing Address
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Address Line | 530 GRIZZLY PEAK BLVD
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City | BERKELEY
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State | CA
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Zip | 94708-1213
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Country | US
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Telephone | 510-527-5626
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Fax | 510-525-2694
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19753
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License Number State | CA
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