Provider Demographics
NPI:1134117435
Name:KNEPFER, ARNOLD (MD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:KNEPFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TAMAL VISTA BLVD
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1130
Mailing Address - Country:US
Mailing Address - Phone:415-927-2320
Mailing Address - Fax:415-927-1225
Practice Address - Street 1:21 TAMAL VISTA BLVD
Practice Address - Street 2:212
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1130
Practice Address - Country:US
Practice Address - Phone:415-927-2320
Practice Address - Fax:415-927-1225
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G54890Medicaid
CA000G54890Medicaid