MEDICARE: DR. DAVID ALFRED PFISTER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	G56495	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110018492	OTHER	CA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689649212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ALFRED PFISTER M.D.

Provider Business Mailing Address
First Line	:	350 30TH ST
Second Line	:	SUITE #525
City	:	OAKLAND
State	:	CA
Zip	:	94609-3424
Country	:	US
Telephone Number	:	510-452-3375
Fax Number	:	510-839-7705

Provider Business Practice Location Address
First Line	:	350 30TH ST
Second Line	:	SUITE #525
City	:	OAKLAND
State	:	CA
Zip	:	94609-3424
Country	:	US
Telephone Number	:	510-452-3375
Fax Number	:	510-839-7705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	12/15/2009

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