Provider Demographics
NPI:1164835542
Name:BRUENSTEINER, HOWARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:BRUENSTEINER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RALEYS TOWNE CTR
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-2440
Mailing Address - Country:US
Mailing Address - Phone:707-585-3444
Mailing Address - Fax:707-584-8519
Practice Address - Street 1:100 RALEYS TOWNE CTR
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2440
Practice Address - Country:US
Practice Address - Phone:707-585-3444
Practice Address - Fax:707-584-8519
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27363183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist