Provider Demographics
NPI:1699974899
Name:ANNE M. CUMMINGS, M.D. A MEDICAL CORPORATION
Entity type:Organization
Organization Name:ANNE M. CUMMINGS, M.D. A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-461-5552
Mailing Address - Street 1:1300 S ELISEO DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2023
Mailing Address - Country:US
Mailing Address - Phone:415-461-5552
Mailing Address - Fax:415-461-8964
Practice Address - Street 1:1300 S ELISEO DR
Practice Address - Street 2:SUITE 201
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2023
Practice Address - Country:US
Practice Address - Phone:415-461-5552
Practice Address - Fax:415-461-8964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA510422349OtherTIN ANNE M. CUMMINGS, M.D
CA900103747OtherEIN ROSS VALLEY MEDICAL C
CA510422349OtherTIN ANNE M. CUMMINGS, M.D