Provider Demographics
NPI:1043572324
Name:GUNN, MARK SPENCER (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:SPENCER
Last Name:GUNN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 S HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-5643
Mailing Address - Country:US
Mailing Address - Phone:562-694-8347
Mailing Address - Fax:562-690-8080
Practice Address - Street 1:355 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-5643
Practice Address - Country:US
Practice Address - Phone:562-694-8347
Practice Address - Fax:562-690-8080
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor