Healthcare Provider Details

I. General information

NPI: 1184571978
Provider Name (Legal Business Name): KEVIN BRANDSTETTER, M.D., A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 BRODERICK STREET
SAN FRANCISCO CA
94117-1413
US

IV. Provider business mailing address

2108 N ST #15129
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 415-325-9560
  • Fax:
Mailing address:
  • Phone: 415-325-9560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN DAVID BRANDSTETTER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 415-325-9560