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General NPI Number Information
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NPI Number | 1902839699
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Entity Type | Individual
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Provider Name | KEVIN DANIEL WHITELAW MD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 747 FIFTY SECOND STREET
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-483-3259
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Fax |
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Provider Business Mailing Address
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Address Line | 240 KENT AVE
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City | KENTFIELD
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State | CA
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Zip | 94904-2525
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Country | US
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Telephone | 415-309-1453
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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 | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | G059070
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License Number State | CA
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