Healthcare Provider Details

I. General information

NPI: 1295024693
Provider Name (Legal Business Name): AMANDA HILER KOHLBRENNER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA MICHELLE HILER MD

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 08/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 CALIFORNIA ST RM 612
SAN FRANCISCO CA
94118-1508
US

IV. Provider business mailing address

3838 CALIFORNIA ST S-612
SAN FRANCISCO CA
94118-1522
US

V. Phone/Fax

Practice location:
  • Phone: 415-254-9344
  • Fax: 415-666-9910
Mailing address:
  • Phone: 415-254-9344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA125334
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: