Basic Information
Provider Information
NPI: 1720323991
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAPPAS
FirstName: KRISTIN
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 420 BAKER ST APT 4
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941171427
CountryCode: US
TelephoneNumber: 5037092761
FaxNumber:  
Practice Location
Address1: 250 BON AIR RD
Address2:  
City: GREENBRAE
State: CA
PostalCode: 949041702
CountryCode: US
TelephoneNumber: 4159257100
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/29/2012
LastUpdateDate: 12/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP3000XA129317CAN Allopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
207L00000X129317CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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