Cunningham, Jason

Cunningham, Jason is an individual health care provider with primary practice located at 6800 Palm Ave Suite C, Sebastopol CA 95472-4269. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Cunningham, Jason can be contacted via phone (707) 824-9999.

Contact Information

Primary practice address
6800 Palm Ave Suite C Sebastopol CA 95472-4269
Phone: (707) 824-9999
Fax: (707) 824-2853
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20A8284 California

Profile Details

NPI number 1811990237
LBN Legal business name Cunningham, Jason
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Jun 25th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811990237 NPPES
California MEDICAID 00AX82840
California MEDICAID 1598768962
California Other ZZZ23666Z
California MEDICAID 1356344758
California MEDICAID 1538334065

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