Provider Demographics
NPI:1659526093
Name:KILBANE, CAMILLA WALDUM (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMILLA
Middle Name:WALDUM
Last Name:KILBANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE # HAN5040
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-5752
Mailing Address - Fax:
Practice Address - Street 1:1635 DIVISADERO ST STE 520
Practice Address - Street 2:UCSF SURGICAL MOVEMENT DISORDERS
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3044
Practice Address - Country:US
Practice Address - Phone:415-353-2311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1106512084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology