Provider Demographics
NPI:1780913442
Name:MASUTTO, KERRI ANN (MD)
Entity type:Individual
Prefix:DR
First Name:KERRI
Middle Name:ANN
Last Name:MASUTTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:ANN
Other - Last Name:MCKIOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:600 CALIFORNIA ST FL 11
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-2727
Mailing Address - Country:US
Mailing Address - Phone:415-515-9382
Mailing Address - Fax:408-618-6272
Practice Address - Street 1:600 CALIFORNIA ST FL 11
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108
Practice Address - Country:US
Practice Address - Phone:415-515-9382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA142746207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine