# KENNETH I. GOTTLIEB, M.D. A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710123112
- **Authorized official:** DR. KENNETH I GOTTLIEB M.D. (PRESIDENT)
- **Authorized official phone:** (415) 346-2103

## Contact information

- **Practice address:** 909 HYDE ST STE 430, SAN FRANCISCO, CA 94109-4846
- **Practice address phone:** (415) 346-2103
- **Mailing address:** 909 HYDE ST STE 430, SAN FRANCISCO, CA 94109-4846
- **Mailing address phone:** (415) 346-2103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084F0202X | Forensic Psychiatry Physician | G23013 | CA | Yes |

## Other

- **Enumeration date:** 01/06/2009
- **Last updated:** 01/06/2009