Individual
MR. KENNETH D. LAXER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 VAN NESS AVE, SAN FRANCISCO, CA 94109-6978
(415) 600-7880
(415) 369-1373
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(415) 600-7880
(415) 369-1373
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G28500
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G285000
—
CA
Enumeration date
03/14/2006
Last updated
05/21/2020
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