Provider Demographics
NPI:1538491253
Name:KATHLEEN BELL UNGER A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:KATHLEEN BELL UNGER A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:BELL
Authorized Official - Last Name:UNGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-776-0456
Mailing Address - Street 1:2000 VAN NESS AVE
Mailing Address - Street 2:SUITE 710/711
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3023
Mailing Address - Country:US
Mailing Address - Phone:415-776-0456
Mailing Address - Fax:415-668-9850
Practice Address - Street 1:2000 VAN NESS AVE
Practice Address - Street 2:SUITE 710/711
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3023
Practice Address - Country:US
Practice Address - Phone:415-776-0456
Practice Address - Fax:415-668-9850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23929101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9452018Medicaid
CAA89391Medicare UPIN