Provider Demographics
NPI:1578076675
Name:BITTNER, CAROLINE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BITTNER
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 HAYES ST STE 208
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1078
Mailing Address - Country:US
Mailing Address - Phone:415-259-4101
Mailing Address - Fax:408-294-6595
Practice Address - Street 1:2250 HAYES ST STE 208
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1078
Practice Address - Country:US
Practice Address - Phone:415-259-4104
Practice Address - Fax:408-294-6595
Is Sole Proprietor?:No
Enumeration Date:2017-11-10
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3466207XX0005X
CA55478207XX0005X, 363A00000X
CAPA55478363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine