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General NPI Number Information
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NPI Number | 1831694660
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Entity Type | Individual
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Provider Name | ALEXANDER D KAZBEROUK
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Gender | Male
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Dates
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Enumeration Date | 03/25/2018
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 840 IRVING ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2311
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Country | US
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Telephone | 888-663-6331
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 1 EMBARCADERO CTR STE 1900
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-3723
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Country | US
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Telephone | 415-658-6791
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | A165392
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD61651857
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License Number State | WA
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Taxonomy #3
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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 #4
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 75788
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | DR.0074505
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License Number State | CO
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