Provider Demographics
NPI:1104812452
Name:BEHR, KATHLEEN L (MD)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:L
Last Name:BEHR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1125 E SPRUCE AVE
Mailing Address - Street 2:#207
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3330
Mailing Address - Country:US
Mailing Address - Phone:559-435-7546
Mailing Address - Fax:559-435-4976
Practice Address - Street 1:1125 E SPRUCE AVE
Practice Address - Street 2:#207
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3330
Practice Address - Country:US
Practice Address - Phone:559-435-7546
Practice Address - Fax:559-435-4976
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2008-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG74167207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F32930Medicare UPIN
CA00G74167Medicare ID - Type Unspecified