MEDICARE: KEVIN CHARLES FELL MD

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	207R00000X	Internal Medicine Physician	A65757	CA
2	207Q00000X	Family Medicine Physician	A65757	CA

General Provider Information

NPI Number	:	1215990494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN CHARLES FELL MD

Provider Business Mailing Address
First Line	:	1 EMBARCADERO CTR STE 1900
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-3723
Country	:	US
Telephone Number	:	415-658-6791
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 W EL CAMINO REAL
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-1306
Country	:	US
Telephone Number	:	415-291-0480
Fax Number	:

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	12/29/2022

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