Provider Demographics
NPI:1073608576
Name:BULOW, KWI YB (MD)
Entity Type:Individual
Prefix:DR
First Name:KWI
Middle Name:YB
Last Name:BULOW
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DR
Mailing Address - Street 2:MC 8201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-9000
Mailing Address - Country:US
Mailing Address - Phone:619-543-1899
Mailing Address - Fax:610-543-3183
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:MC 8201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:619-543-1899
Practice Address - Fax:610-543-3183
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG56674207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAX57986Medicare UPIN