Provider Demographics
NPI:1851639025
Name:MARILYN KUTZSCHER MD INC
Entity Type:Organization
Organization Name:MARILYN KUTZSCHER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTZSCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-923-3560
Mailing Address - Street 1:2100 WEBSTER STREET
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2381
Mailing Address - Country:US
Mailing Address - Phone:415-923-3560
Mailing Address - Fax:415-923-3525
Practice Address - Street 1:2100 WEBSTER STREET
Practice Address - Street 2:SUITE 501
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2381
Practice Address - Country:US
Practice Address - Phone:415-923-3560
Practice Address - Fax:415-923-3525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49471207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty