Provider Demographics
NPI:1750627071
Name:NONA M CUNNINGHAM MD INC
Entity type:Organization
Organization Name:NONA M CUNNINGHAM MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NONA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-747-6769
Mailing Address - Street 1:PO BOX 150030
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94915-0030
Mailing Address - Country:US
Mailing Address - Phone:415-461-1149
Mailing Address - Fax:415-925-1156
Practice Address - Street 1:599 SIR FRANCIS DRAKE BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1712
Practice Address - Country:US
Practice Address - Phone:415-747-6769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG059410207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN