Basic Information
| Provider Information | |||||||||
| NPI: | 1710197165 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KU | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | I.M.F. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 EXECUTIVE PARK BLVD | ||||||||
| Address2: | SUITE 4900 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941343394 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156560116 | ||||||||
| FaxNumber: | 4156560117 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 EXECUTIVE PARK BLVD | ||||||||
| Address2: | SUITE 4900 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941343394 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156560116 | ||||||||
| FaxNumber: | 4156560117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 07/23/2014 | ||||||||
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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 | 106H00000X | IMF73188 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.