Basic Information
| Provider Information | |||||||||
| NPI: | 1447280813 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ERLICH | ||||||||
| FirstName: | KIM | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 839 COWAN RD | ||||||||
| Address2: | |||||||||
| City: | BURLINGAME | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940101204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6506785079 | ||||||||
| FaxNumber: | 6506858043 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 TROUSDALE DR | ||||||||
| Address2: | |||||||||
| City: | BURLINGAME | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940104506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6506785079 | ||||||||
| FaxNumber: | 6509695777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 05/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | G52407 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 00G524070 | 05 | CA | MEDICAID |