Healthcare Provider Details

I. General information

NPI: 1750440194
Provider Name (Legal Business Name): RICHARD A NUSSER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 HAWTHORNE AVE SUITE 202
OAKLAND CA
94609
US

IV. Provider business mailing address

365 HAWTHORNE AVE SUITE 202
OAKLAND CA
94609
US

V. Phone/Fax

Practice location:
  • Phone: 510-451-6074
  • Fax: 510-451-2620
Mailing address:
  • Phone: 510-451-6074
  • Fax: 510-451-2620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberC337330
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberC337330
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberC337330
License Number StateCA

VIII. Authorized Official

Name: MS. LINDA E HAWK
Title or Position: OFFICE MANAGER
Credential: NP
Phone: 510-451-6074