Individual
DR. KIDIST KIDANE YIMAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1100 VAN NESS AVE, SAN FRANCISCO, CA 94109-6978
(415) 600-1020
(415) 922-1594
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(415) 600-1594
(415) 922-1594
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
A103412
CA
207R00000X
Internal Medicine Physician
A103412
CA
207RG0100X
Gastroenterology Physician
A103412
CA
207RI0008X
Hepatology Physician
A103412
CA
207RT0003X
Transplant Hepatology Physician
Primary
906368
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A103412
STATE MEDICAL LICENSE
CA
Enumeration date
10/21/2008
Last updated
11/16/2020
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