Individual
DR. DAVID S FANKUSHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12 RITTER ST, SAN RAFAEL, CA 94912
(415) 457-8182
(415) 457-3490
Mailing address
16 RITTER ST, SAN RAFAEL, CA 94901-3323
(415) 457-8182
(415) 457-3490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
GFE10777
CA
Other
Enumeration date
07/05/2007
Last updated
07/08/2007
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