Organization Active NPI

Kenneth I. Gottlieb, M.D. a Professional Corporation

  • Forensic Psychiatry Physician
  • San Francisco, CA
National Provider Identifier
1710123112
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
G23013 Issued in CA
Legal business name
KENNETH I. GOTTLIEB, M.D. A PROFESSIONAL CORPORATION
Practice address
909 Hyde St Ste 430
San Francisco, CA 94109-4846
Phone
(415) 346-2103
NPI assigned
Jan 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kenneth I Gottlieb, M.D.
Title
President
Phone
(415) 346-2103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084F0202X G23013 CA Primary

Addresses

Primary practice location

909 Hyde St Ste 430
San Francisco, CA 94109-4846

Mailing address

909 Hyde St Ste 430
San Francisco, CA 94109-4846
Phone (415) 346-2103

National Provider Directory

National Provider Directory

Locations

909 Hyde St
Ste 430
San Francisco, CA 94109
Phone (415) 346-2103

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1710123112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 HYDE ST STE 430",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094846",
            "telephone_number": "415-346-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 HYDE ST STE 430",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094846",
            "telephone_number": "415-346-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH I. GOTTLIEB, M.D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "GOTTLIEB",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-346-2103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "G23013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.