MEDICARE: MR. KEVIN DEAN MORSE M.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	2084P0800X	Psychiatry Physician	G46678	CA

General Provider Information

NPI Number	:	1255478947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KEVIN DEAN MORSE M.D.

Provider Business Mailing Address
First Line	:	1570 THE ALAMEDA
Second Line	:	STE 228
City	:	SAN JOSE
State	:	CA
Zip	:	95126-2305
Country	:	US
Telephone Number	:	408-293-3888
Fax Number	:	408-293-1029

Provider Business Practice Location Address
First Line	:	1570 THE ALAMEDA STE 228
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95126-2305
Country	:	US
Telephone Number	:	408-293-3888
Fax Number	:	408-293-1029

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	07/16/2023

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