Provider Demographics
NPI:1205922085
Name:SHUNK, REBECCA LESTO (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LESTO
Last Name:SHUNK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4150 CLEMENT ST
Mailing Address - Street 2:SFVAMC
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1545
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:415-750-6614
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:SFVAMC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0050624207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA02475AMedicare UPIN