Individual
JESSE CHARLES NUSSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
513 PARNASSUS AVE, BOX 0654, SAN FRANCISCO, CA 94143-2205
(415) 476-9363
Mailing address
513 PARNASSUS AVE, CAMPUS BOX 0654, SAN FRANCISCO, CA 94143-2205
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A105020
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35882
CONTROLLED SUBSTANCE NO
CT
Enumeration date
04/03/2007
Last updated
06/30/2010
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