MEDICARE: DR. BERND MICHAEL KUTZSCHER M.D.

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	207W00000X	Ophthalmology Physician	G53132	CA

General Provider Information

NPI Number	:	1891791133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERND MICHAEL KUTZSCHER M.D.

Provider Business Mailing Address
First Line	:	1850 SULLIVAN AVE
Second Line	:	STE 540
City	:	DALY CITY
State	:	CA
Zip	:	94015-2215
Country	:	US
Telephone Number	:	650-755-6900
Fax Number	:	650-755-2107

Provider Business Practice Location Address
First Line	:	1850 SULLIVAN AVE
Second Line	:	STE 540
City	:	DALY CITY
State	:	CA
Zip	:	94015-2215
Country	:	US
Telephone Number	:	650-755-6900
Fax Number	:	650-755-2107

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	09/24/2010

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