Healthcare Provider Details

I. General information

NPI: 1295888253
Provider Name (Legal Business Name): DR. TOMAS DOLF ZILLMANN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 RHODE ISLAND ST STE 200
SAN FRANCISCO CA
94103-5188
US

IV. Provider business mailing address

PO BOX 276950
SACRAMENTO CA
95827-6950
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-6240
  • Fax: 415-366-7574
Mailing address:
  • Phone: 415-600-6240
  • Fax: 415-366-7574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG86306
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: