Provider Demographics
NPI:1265454029
Name:CUMMINGS, DEAN W (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:W
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 HOSPITAL DR
Mailing Address - Street 2:BLDG # 7
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4106
Mailing Address - Country:US
Mailing Address - Phone:650-965-3243
Mailing Address - Fax:650-965-4638
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:BLDG # 7
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4106
Practice Address - Country:US
Practice Address - Phone:650-965-3243
Practice Address - Fax:650-965-4638
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A57736Medicare UPIN
CA000G71140Medicare ID - Type Unspecified