DR. DAVID S FANKUSHEN (NPI# 1174721856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174721856 |
| Entity Type | Individual |
| Full Name | DR. DAVID S FANKUSHEN |
| Credential | M.D. |
| Practice Address |
12 Ritter St San Rafael CA 94912 |
| Mailing Address |
16 Ritter St San Rafael CA 94901-3323 |
| Practice Telephone | 4154578182 |
| Practice Fax Number | 4154573490 |
| Mailing Telephone | 4154578182 |
| Mailing Fax Number | 4154573490 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | GFE10777 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
12 RITTER ST |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881059210 | Dominique Mc Dowell | Counselor | 16 Ritter St, San Rafael, CA 94912-3517 | 2015-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748292 | Roy C Solitana | Nurse Practitioner | 1545 4th St Apt 1, San Rafael, CA 94901-2744 | 2020-10-21 |
| 1063019073 | Denise Angela Joan Mitchell | Massage Therapist | 131 Roundtree Blvd, San Rafael, CA 94903-1639 | 2020-10-02 |
| 1962011551 | Madrona Hospice Care Inc | Hospice Care, Community Based | 185 N Redwood Dr Ste 110, San Rafael, CA 94903-1973 | 2020-07-29 |
| 1891304895 | Argie Gulapa Vila | Nurse Practitioner | 175 N Redwood Dr Ste 285, San Rafael, CA 94903-1972 | 2020-07-24 |
| 1770191538 | Deirdre Ann Martinez | Student in an Organized Health Care Education/Training Program | 66 Oxford Dr, San Rafael, CA 94903-2887 | 2020-07-17 |
| 1700404977 | Top Drawer Health Inc. | Nurse Practitioner | 244 Humboldt St, San Rafael, CA 94901-1025 | 2020-07-14 |
| 1386269660 | Heartwood House LLC | Clinic/Center | 8 Circle Rd, San Rafael, CA 94903-3821 | 2020-06-11 |
| 1043833841 | Kevin Nasre | Student in an Organized Health Care Education/Training Program | 103 Gable Ct, San Rafael, CA 94903-5208 | 2020-05-27 |
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1285256081 | Aloizio Veronico Costa | Driver | 1435 4th St, San Rafael, CA 94901-2847 | 2020-05-14 |
| Find all providers in SAN RAFAEL | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811558349 | Gerard Fuertes Notario | Internal Medicine | 74 Rafael Dr, San Rafael, CA 94901-2225 | 2019-06-25 |
| 1205233889 | Annette S Thorn | Internal Medicine | 161 Maywood Way, San Rafael, CA 94901 | 2014-11-26 |
| 1306245279 | Charles Fischer | Internal Medicine | 75 Dunfries Ter, San Rafael, CA 94901-2415 | 2014-08-17 |
| 1326386897 | James D Taylor Md Inc | Internal Medicine | 155 Andersen Dr Ste 1108, San Rafael, CA 94901-3999 | 2013-01-17 |
| 1104139633 | Henry N Hulter | Internal Medicine | 17 Wellbrock Hts, San Rafael, CA 94903-3787 | 2010-07-26 |
| 1609946755 | Lynette Teresa Mclamb | Internal Medicine | 1033 3rd Street, Kaiser Permanente Adult Medicine, San Rafael, CA 94901 | 2006-11-08 |
| 1447343496 | Fareed Ramzi Asfour | Internal Medicine | 834 5th Ave Ste 2, San Rafael, CA 94901-3254 | 2006-10-02 |
| 1235243775 | Bryn James Duffy | Internal Medicine | 16 Bolanos Dr, San Rafael, CA 94903-3103 | 2006-08-19 |
| 1851331094 | Jonathan M Freudman | Internal Medicine | 1010 B St, Suite 208, San Rafael, CA 94901-2922 | 2006-06-07 |
| 1760439681 | Joseph A. Habis | Internal Medicine | 4000 Civic Center Dr., #200b, San Rafael, CA 94903 | 2006-05-27 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94912 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.