MEDICARE: DR. WING K KAM M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	G43959	CA

General Provider Information

NPI Number	:	1003964826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WING K KAM M.D., PH.D.

Provider Business Mailing Address
First Line	:	G I UNIT L103
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-0001
Country	:	US
Telephone Number	:	415-831-8383
Fax Number	:	415-831-6988

Provider Business Practice Location Address
First Line	:	3838 CALIFORNIA ST RM 108
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1504
Country	:	US
Telephone Number	:	415-831-8383
Fax Number	:	415-831-6988

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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