Provider Demographics
NPI:1891737003
Name:LOUIE, KEVIN W (M D)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:W
Last Name:LOUIE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2100 WEBSTER ST STE 117
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2374
Mailing Address - Country:US
Mailing Address - Phone:415-417-3330
Mailing Address - Fax:415-417-3301
Practice Address - Street 1:2100 WEBSTER ST
Practice Address - Street 2:#117
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2373
Practice Address - Country:US
Practice Address - Phone:415-417-3300
Practice Address - Fax:415-417-3301
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2021-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45653207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G456530OtherBLUE CROSS BLUE SHIELD #
CA200036385OtherRAILROAD MEDICARE NUMBER
CA197427400OtherWORKERS COMPENSATION
CAA50131Medicare UPIN
CA00G456530Medicare PIN
CA197427400OtherWORKERS COMPENSATION