Provider Demographics
NPI:1427040732
Name:DENNY, KEVIN JOHN (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:JOHN
Last Name:DENNY
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 1:711 VAN NESS AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3244
Mailing Address - Country:US
Mailing Address - Phone:415-567-8200
Mailing Address - Fax:415-567-2973
Practice Address - Street 1:711 VAN NESS AVE STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3286
Practice Address - Country:US
Practice Address - Phone:415-567-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44848207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-3017042OtherTAX ID
CAA49775Medicare UPIN
00G448480Medicare ID - Type Unspecified