Provider Demographics
NPI:1336175967
Name:NOVAK, KIRSTEN LEAH (MD)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:LEAH
Last Name:NOVAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:130 SUTTER ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4009
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:590 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2611
Practice Address - Country:US
Practice Address - Phone:650-288-4080
Practice Address - Fax:650-288-4180
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT3761041205207R00000X
CA83443207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine