# PATRICK TIMOTHY FUSUNYAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1811564776
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OT020938 | PA | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | 20A24331 | CA | Yes |

## Other

- **Enumeration date:** 06/09/2021
- **Last updated:** 02/25/2026