Provider Demographics
NPI:1104882653
Name:KAISER, THOMAS JOSEPH (MD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:KAISER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TOM
Other - Middle Name:J
Other - Last Name:KAISER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:45 CASTRO ST
Mailing Address - Street 2:#302
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114
Mailing Address - Country:US
Mailing Address - Phone:415-565-0320
Mailing Address - Fax:415-861-4169
Practice Address - Street 1:45 CASTRO ST
Practice Address - Street 2:#302
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114
Practice Address - Country:US
Practice Address - Phone:415-565-0320
Practice Address - Fax:415-861-4169
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC25587207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C255870Medicaid
CA00C255870Medicaid
CA00C255870Medicare PIN