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NPI Code Detail

MEDICARE: MR. KAMTHA KEOW M.F.T.I

MEDICARE: MR. KAMTHA KEOW M.F.T.I
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
1106H00000XMarriage & Family Therapist85061CA

General Provider Information

NPI Number : 1629291430
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KAMTHA KEOW M.F.T.I
Provider Business Mailing Address
First Line : 368 FELL ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-5144
Country : US
Telephone Number : 415-861-0828
Fax Number : 415-861-0257
Provider Business Practice Location Address
First Line : 2481 HARRISON ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94110-2710
Country : US
Telephone Number : 415-285-8100
Fax Number : 415-285-2448
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 08/05/2017

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