Provider Demographics
NPI:1639211683
Name:NORMAN, KIM PETER (MD)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:PETER
Last Name:NORMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:117 SPYGLASS LN
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-8002
Mailing Address - Country:US
Mailing Address - Phone:650-726-1183
Mailing Address - Fax:415-502-2661
Practice Address - Street 1:401 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2211
Practice Address - Country:US
Practice Address - Phone:415-476-7402
Practice Address - Fax:415-502-2661
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG381002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry