Meet the Physicians

Dinah Bukowski, MD

Specialty: Critical Care, Pulmonology

Dr. Bukowski is a graduate of the University of Texas at Austin. She completed her medical school, internal medicine residency, and fellowship in pulmonology & critical care at the University of Texas Health Science Center in San Antonio, Texas. She went on to serve as an associate professor of pulmonary and critical care medicine at this facility.

From 1994 until 2003, she practiced in Austin, Texas. While there she served as co-chairman of the Critical Care Unit at Seton Hospital and was chief of medicine at the Heart Hospital of Austin. In 2003, she moved to the Big Island of Hawaii where she continued to practice pulmonary & critical care medicine and started the hospitalist program at North Hawaii Community Hospital.

In May 2017, she took on some hospitalist shifts at Marin General Hospital. She has so enjoyed the staff and the medical community here, she has decided to make Marin her home.

Dinah enjoys caring for medically complex patients, and in her free time enjoys surfing and open water swimming in the Pacific. Albeit a tad cooler here than in Hawaii, she is readily adapting.


Guy Livnat, MD, FCCP

Specialty: Critical Care, Pulmonology

Dr. Guy Livnat received his Bachelors and Medical degrees from Tel Aviv University in Israel. Dr Livnat trained in pulmonary and critical care at the St Elizabeth’s Medical Center of Boston, where he stayed on as junior attending staff for 2 years. He later moved to the bay area and completed a sub fellowship in pulmonary hypertension at Stanford University Medical Center. He has been in practice in Marin County for over 7 years.

Dr. Livnat is an outdoor enthusiast; he has backpacked/climbed in Pakistan, Scandinavia, the Alps Patagonia, Mexico and the US.


Merrill Nisam, MD, FCCP, FACP

Specialty: Critical Care, Internal Medicine, Pulmonology

Dr. Nisam is the Medical Director of Critical Care and Director of Respiratory Therapy at Marin General Hospital, in addition to being a pulmonary consultant for complex lung and intensive care medical problems. He teaches physicians-in-training at UCSF, serving as Associate Professor of Medicine, Pulmonary Dept.

He also is rewarded by helping patients in the office, with pulmonary conditions such as: asthma, pneumonias, recurrent airway infections, chronic cough, COPD, smoking cessation, chest pain & shortness of breath evaluations, pulmonary embolism, pulmonary hypertension, pneumothorax, improving exercise lung performance, lung nodules/abnormalities seen on chest x-ray or CT scans, and sleep apnea – signaled usually by snoring and excessive daytime somnolence. He currently practices in Greenbrae and San Rafael-Terra Linda, California.

Dr. Nisam takes special interest in clear and concise communication with patients; using email for updates, and quick memos, plus offering patients a printed office note summarizing medical information, as one is leaving the office. We use a HIPPA compliant confidential electronic medical record, which instantly shares all medical data with other Marin MD’s, labs, and the two main hospitals – MGH, and NCH. He also encourages people to take a pro-active role for themselves, seeking appropriate information, actively participating in their care, and pursuing their own benefits.

He was born in the U.S., and educated at U.C. Berkeley in biological sciences, and then medicine from U.C. Davis in 1980, then subspecialty training in pulmonary and critical care at California Pacific Medical Center. For a couple years, he did primary medical science-asthma research at UCSF. While a medical student, Dr. Nisam flew as a pilot for “flying doctors” on relief missions in rural Mexico, and worked briefly in Lausanne, Switzerland, so he speaks conversational French. He has traveled extensively, enjoys kiteboarding, windsurfing, wilderness skiing, mountain bike riding, and his kids-family.


Randall A. Ichihana, RPFT

Specialty: Pulmonology

Randall A. Ichihana, RPFT, joined Prima Medical Group in October of 2014. Prior to working with Prima he founded Marin Pulmonary Service, Marin County’s premier pulmonary testing service. Mr. Ichihana studied Respiratory Therapy graduating with top honors from the distinguished Institute of Medical Studies, located in Berkeley, California. He is also a Board Registered Pulmonary Function Technologist (RPFT). He is a member of the American Association for Respiratory Care (AARC) and the National Board for Respiratory Care (NBRC). Mr. Ichihana has been practicing in Marin County for 37 years. In his spare time, he enjoys traveling, fishing, and when the snow is good, escaping to Tahoe for some skiing.

He works very closely with our pulmonary care physicians. He also does testing for many Marin County specialists and Primary Care physicians who need information on lung function to most effectively care for their patients.
Prima offers a full line of Pulmonology testing including:
• Spirometry with bronchodilators.
• Lung Volumes: useful for determining the presence and severity of restrictive lung disease.
• Diffuse Capacity (DLCO): Diffusion of gas for the alveoli to the pulmonary circulation is measured. Useful for determining the presence of pulmonary vascular disease, interstitial lung disease, and emphysema. Hemoglobin will be measured for DLCO correction
• Niox Testing for Asthma Management
• Spirometry and Spirometry with Bronchodilator
• Oximetry
• Six Minute Walk Tests, and
• Methacholine Challenge


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