Provider Demographics
NPI:1891791133
Name:KUTZSCHER, BERND MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:BERND
Middle Name:MICHAEL
Last Name:KUTZSCHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1850 SULLIVAN AVE
Mailing Address - Street 2:STE 540
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2215
Mailing Address - Country:US
Mailing Address - Phone:650-755-6900
Mailing Address - Fax:650-755-2107
Practice Address - Street 1:1850 SULLIVAN AVE
Practice Address - Street 2:STE 540
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2215
Practice Address - Country:US
Practice Address - Phone:650-755-6900
Practice Address - Fax:650-755-2107
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2010-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG53132207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5116580001Medicare NSC
CA00G531324Medicare PIN
A52451Medicare UPIN
CA00G531323Medicare PIN