MEDICARE: KURT HOYT KUNZEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	G34671	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00G346710	OTHER	CA	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073502696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KURT HOYT KUNZEL MD

Provider Business Mailing Address
First Line	:	1000 MASON ST
Second Line	:	#905
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94108-1919
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 CIVIC CENTER DR
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-4171
Country	:	US
Telephone Number	:	209-342-2300
Fax Number	:	209-524-4240

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	07/27/2012

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