Basic Information
| Provider Information | |||||||||
| NPI: | 1316233844 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUSHNIR | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | Y. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3626 RUFFIN RD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921231810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585659666 | ||||||||
| FaxNumber: | 8585659441 | ||||||||
| Practice Location | |||||||||
| Address1: | 3626 RUFFIN RD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921231810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585659666 | ||||||||
| FaxNumber: | 8585659441 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2011 | ||||||||
| LastUpdateDate: | 10/12/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LC0200X | A136439 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207L00000X | A136439 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.