Healthcare Provider Details

I. General information

NPI: 1285551820
Provider Name (Legal Business Name): FERNANDO AUGUSTO TAVARES CANHISARES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: FERNANDO CANHISARES

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 PARNASSUS AVE 4TH FLOOR CAMPUS BOX: 0648
SAN FRANCISCO CA
94143-2206
US

IV. Provider business mailing address

521 PARNASSUS AVE 4TH FLOOR CAMPUS BOX: 0648
SAN FRANCISCO CA
94143-2206
US

V. Phone/Fax

Practice location:
  • Phone: 240-994-5179
  • Fax:
Mailing address:
  • Phone: 240-994-5179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberSPI968
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: