MEDICARE: ANDREAS KAMLOT 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	208600000X	Surgery Physician	A69922	CA

General Provider Information

NPI Number	:	1720019748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREAS KAMLOT MD

Provider Business Mailing Address
First Line	:	1320 EL CAPITAN DR
Second Line	:	STE 120
City	:	DANVILLE
State	:	CA
Zip	:	94526-6258
Country	:	US
Telephone Number	:	925-676-2600
Fax Number	:	925-689-3102

Provider Business Practice Location Address
First Line	:	1320 EL CAPITAN DR
Second Line	:	STE 120
City	:	DANVILLE
State	:	CA
Zip	:	94526-6258
Country	:	US
Telephone Number	:	925-676-2600
Fax Number	:	925-689-3102

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	05/11/2020

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