Provider Demographics
NPI:1821433285
Name:MENUT, KATHRYN HELEN C (MD, MS)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:HELEN C
Last Name:MENUT
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:HELEN
Other - Last Name:CHOMSKY-HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 DIVISADERO ST FL 4
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-3010
Mailing Address - Country:US
Mailing Address - Phone:415-353-6867
Mailing Address - Fax:
Practice Address - Street 1:1600 DIVISADERO ST FL 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-3010
Practice Address - Country:US
Practice Address - Phone:415-353-6867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA135040208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA135040OtherSTATE MEDICAL LICENSE