David S Fankushen, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

GFE10777 Issued in CA

Practice address

12 Ritter St
San Rafael, CA 94912

Phone

(415) 457-8182

Fax

(415) 457-3490

NPI assigned

Jul 5, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174721856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 RITTER ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013323",
            "telephone_number": "415-457-8182",
            "fax_number": "415-457-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 RITTER ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94912",
            "telephone_number": "415-457-8182",
            "fax_number": "415-457-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANKUSHEN",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "GFE10777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Service Agency of Marin
• Family Service Agency of Marin
• Family Service Agency of Marin
• Family Works
• Samantha Xiaoying Fang, PA-C
• Megan Fannin, RD
• David Faridi, CNMT, CT
• Gabriel Farkas, MD
• Nicole Farkas
• Celeste E Farmer

• Internal Medicine Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.