Provider Demographics
NPI:1427476514
Name:STERN, KEN MURAKAMI (MD)
Entity type:Individual
Prefix:
First Name:KEN
Middle Name:MURAKAMI
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 WEBSTER ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3125
Mailing Address - Country:US
Mailing Address - Phone:510-271-4400
Mailing Address - Fax:844-852-1277
Practice Address - Street 1:3300 WEBSTER ST STE 1000
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3125
Practice Address - Country:US
Practice Address - Phone:510-271-4400
Practice Address - Fax:844-852-1277
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA137706207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAKS3232267556Medicaid