Alexis Christine Kofoed, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA55669 Issued in CA

Practice address

1 Embarcadero Ctr # R-1203
San Francisco, CA 94111-3628

Phone

(707) 673-6506

NPI assigned

Jun 25, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1770078479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 SEMINOLE CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945347871",
            "telephone_number": "707-673-6506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR # R-1203",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628",
            "telephone_number": "707-673-6506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFOED",
        "first_name": "ALEXIS",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA55669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA55669",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Koenig, BCBA
• Lorin A. Koenig, L.C.S.W.
• Maegann Koenig
• Chris I Koeplin, P.T.
• Rachel Bemis Koff, MS
• Randi Kofsky
• Irene Koga, OD
• Anya V Kogan, PHD
• Scott C. Kogan, M.D.
• Yana Kogan, PHARM.D,

• Medical Physician Assistant in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.