Provider Demographics
NPI:1295024693
Name:KOHLBRENNER, AMANDA HILER (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:HILER
Last Name:KOHLBRENNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MICHELLE
Other - Last Name:HILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3838 CALIFORNIA ST
Mailing Address - Street 2:S-612
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1522
Mailing Address - Country:US
Mailing Address - Phone:415-254-9344
Mailing Address - Fax:
Practice Address - Street 1:3838 CALIFORNIA ST
Practice Address - Street 2:RM 612
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1508
Practice Address - Country:US
Practice Address - Phone:415-254-9344
Practice Address - Fax:415-666-9910
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA125334208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program