Healthcare Provider Details

I. General information

NPI: 1326150384
Provider Name (Legal Business Name): MARILYN M KUTZSCHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER ST STE 501
SAN FRANCISCO CA
94115-2381
US

IV. Provider business mailing address

2100 WEBSTER ST STE 501
SAN FRANCISCO CA
94115-2381
US

V. Phone/Fax

Practice location:
  • Phone: 415-923-3560
  • Fax: 415-923-3525
Mailing address:
  • Phone: 415-923-3560
  • Fax: 415-923-3525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG49471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: