Awakenmd PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

AWAKENMD PC

Doing business as

AwakenMD

Practice address

95 Town and Country Village
Palo Alto, CA 94301-2341

Phone

(650) 251-4722

Fax

(650) 421-7494

NPI assigned

Jun 15, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Sean E Bourke, M.D.

Title

Founder and Medical Director

Phone

(650) 274-6256

Specialties & licenses 1

Addresses

Other names 1

• AwakenMD Doing business as

Locations

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465948800000",
    "number": "1922458439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 STANFORD SHOPPING CENTER",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041423",
            "telephone_number": "650-251-4722",
            "fax_number": "650-421-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 TOWN AND COUNTRY VILLAGE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012341",
            "telephone_number": "650-251-4722",
            "fax_number": "650-421-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKENMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A",
        "authorized_official_last_name": "BOURKE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "FOUNDER AND MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "650-274-6256",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AwakenMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mona Avaz, LCSW
• Nicholas Andrew Avdimiretz, MD
• Wendy Avelar
• Jonathan Tiago Avila, M.D.
• Rania Awaad, MD
• David Michael Axelrod, M.D.
• Kathryn Sarah Axsom, APN
• Tandy Aye, MD
• Eve Ariel Ayeroff, MD
• Ruthie Maryanne Ayzenberg

• General Practice Physician in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.