# KEITH F KORVER MD A PROFESSIONAL MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1790819613
- **Authorized official:** KEITH F KORVER M.D. (PRESIDENT)
- **Authorized official phone:** (707) 569-7860

## Contact information

- **Practice address:** 2 BON AIR RD, STE 100, LARKSPUR, CA 94939-1144
- **Practice address phone:** (415) 927-0666
- **Practice address fax:** (415) 927-6168
- **Mailing address:** 3510 UNOCAL PL STE 207, SANTA ROSA, CA 95403-0918
- **Mailing address phone:** (707) 569-7860
- **Mailing address fax:** (707) 545-5408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 07/15/2021