Provider Demographics
NPI:1619910726
Name:BICKEL, KYLE D (MD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:D
Last Name:BICKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 CALIFORNIA ST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4586
Mailing Address - Country:US
Mailing Address - Phone:415-751-4263
Mailing Address - Fax:415-359-1925
Practice Address - Street 1:1700 CALIFORNIA ST
Practice Address - Street 2:SUITE 450
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4586
Practice Address - Country:US
Practice Address - Phone:415-751-4263
Practice Address - Fax:415-359-1925
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65480207XS0106X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4019270001OtherCIGNA MEDICARE NUMBER
CA193420600OtherWORK COMPENSATION NUMBER
CA020045873OtherRAILROAD MEDICARE NUMBER
CA912006609OtherTRICARE PROVIDER NUMBER
CA193420600OtherWORK COMPENSATION NUMBER
CA00G654800Medicare PIN