Provider Demographics
NPI:1942573258
Name:KIEFER, MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:KIEFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 EAST 31ST STREET
Mailing Address - Street 2:HIGHLAND GENERAL HOSPITAL
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1092
Mailing Address - Country:US
Mailing Address - Phone:917-699-8581
Mailing Address - Fax:
Practice Address - Street 1:1411 EAST 31ST STREET
Practice Address - Street 2:ALAMEDA COUNTY MEDICAL CENTER - HIGHLAND CAMPUS
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1092
Practice Address - Country:US
Practice Address - Phone:917-699-8581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123937207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine