Individual
MATTHEW HARRISON KANZLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 KEARNEY STREET, DERMATOLOGY DEPARTMENT, FREMONT, CA 94538-2299
(510) 490-1222
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(510) 498-2374
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G57056
CA
207ND0900X
Dermatopathology Physician
G57056
CA
207NS0135X
Procedural Dermatology Physician
G57056
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G570560
—
CA
Enumeration date
04/12/2006
Last updated
05/28/2020
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