MEDICARE: DR. LAURA B KINSEL 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	G067635	CA

General Provider Information

NPI Number	:	1518142926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA B KINSEL MD

Provider Business Mailing Address
First Line	:	1216 LEVIN AVE
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-3905
Country	:	US
Telephone Number	:	650-965-3817
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 LEVIN AVE
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-3905
Country	:	US
Telephone Number	:	650-965-3817
Fax Number	:

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

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	01/03/2008

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