Provider Demographics
NPI:1861676777
Name:KEMP, DONALD J JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:J
Last Name:KEMP
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:DON
Other - Middle Name:
Other - Last Name:KEMP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:2151 SACRAMENTO ST
Mailing Address - Street 2:APT 1
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3337
Mailing Address - Country:US
Mailing Address - Phone:865-567-7020
Mailing Address - Fax:
Practice Address - Street 1:170 ALAMEDA DE LAS PULGAS
Practice Address - Street 2:SEQUIOA HOSPITAL
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2751
Practice Address - Country:US
Practice Address - Phone:650-369-5811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19556363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant