Provider Demographics
NPI:1174638555
Name:KIPROV, DOBRI D (MD, PC)
Entity Type:Individual
Prefix:
First Name:DOBRI
Middle Name:D
Last Name:KIPROV
Suffix:
Gender:M
Credentials:MD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MARTHA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-2835
Mailing Address - Country:US
Mailing Address - Phone:415-649-0643
Mailing Address - Fax:
Practice Address - Street 1:2100 WEBSTER ST STE 512
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2381
Practice Address - Country:US
Practice Address - Phone:415-923-3646
Practice Address - Fax:415-928-4642
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36454207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A364541Medicare ID - Type Unspecified