Provider Demographics
NPI:1942998745
Name:ENG, KEVIN ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ALEXANDER
Last Name:ENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 PARNASSUS EDUCATION OFFICE
Mailing Address - Street 2:RM S257 BOX 0628
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:415-502-2673
Mailing Address - Fax:415-476-0616
Practice Address - Street 1:513 PARNASSUS EDUCATION OFFICE
Practice Address - Street 2:RM S257
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-502-2673
Practice Address - Fax:415-476-0616
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program