Provider Demographics
NPI:1720222169
Name:KIEFER, RENATA G (MD)
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:G
Last Name:KIEFER
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 1:6 LOCKSLEY AVE
Mailing Address - Street 2:#10A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-3854
Mailing Address - Country:US
Mailing Address - Phone:415-731-3672
Mailing Address - Fax:
Practice Address - Street 1:6 LOCKSLEY AVE APT 10A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-3878
Practice Address - Country:US
Practice Address - Phone:415-731-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53596208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics