Provider Demographics
NPI:1215960430
Name:SOMKIN, ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:SOMKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1310 COMMERCE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-1469
Mailing Address - Country:US
Mailing Address - Phone:707-778-7862
Mailing Address - Fax:707-778-0969
Practice Address - Street 1:2500 MILVIA ST
Practice Address - Street 2:SUITE 228
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2636
Practice Address - Country:US
Practice Address - Phone:510-548-8888
Practice Address - Fax:510-845-8313
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2008-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC33404207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C334040Medicare PIN
CAA35261Medicare UPIN