Individual
SONJA KASSUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 HAWTHORNE AVE RM 2346, OAKLAND, CA 94609
(510) 869-8373
(510) 869-8375
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(510) 869-8373
(510) 869-8375
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C51995
CA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
C51995
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C51995
STATE MEDICAL LICENSE
CA
Enumeration date
05/04/2006
Last updated
10/22/2019
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