Provider Demographics
NPI:1104991769
Name:STONE, KEVIN R (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:R
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3727 BUCHANAN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-5410
Mailing Address - Country:US
Mailing Address - Phone:415-563-3110
Mailing Address - Fax:415-563-3301
Practice Address - Street 1:3727 BUCHANAN ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-1779
Practice Address - Country:US
Practice Address - Phone:415-563-3110
Practice Address - Fax:415-563-3301
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2023-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA39288174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA28860Medicare UPIN