Provider Demographics
NPI:1407241581
Name:FABERSUNNE, CAMILA SUSANA CRIBB (MD, MPH)
Entity Type:Individual
Prefix:
First Name:CAMILA
Middle Name:SUSANA CRIBB
Last Name:FABERSUNNE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 0110
Mailing Address - Street 2:550 16TH STREET, 4TH FLOOR, 4551
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0001
Mailing Address - Country:US
Mailing Address - Phone:415-476-9000
Mailing Address - Fax:
Practice Address - Street 1:1975 4TH ST
Practice Address - Street 2:UCSF BENIOFF CHILDREN'S HOSPITAL
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2351
Practice Address - Country:US
Practice Address - Phone:415-476-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-05
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA146835208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics