Provider Demographics
NPI:1710992516
Name:KACHER COBB, JILL M (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:M
Last Name:KACHER COBB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:KACHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3000 COLBY ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2083
Mailing Address - Country:US
Mailing Address - Phone:510-666-0854
Mailing Address - Fax:510-666-1192
Practice Address - Street 1:3000 COLBY ST
Practice Address - Street 2:SUITE 205
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2083
Practice Address - Country:US
Practice Address - Phone:510-666-0854
Practice Address - Fax:510-666-1192
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82012207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A820120Medicaid
CAP00612389Medicare PIN
CA00A820120Medicaid
I34410Medicare UPIN