Provider Demographics
NPI:1427203355
Name:STEPHEN R BUNKER MD
Entity Type:Organization
Organization Name:STEPHEN R BUNKER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-921-7226
Mailing Address - Street 1:1700 CALIFORNIA ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4586
Mailing Address - Country:US
Mailing Address - Phone:415-921-7226
Mailing Address - Fax:415-921-7225
Practice Address - Street 1:1700 CALIFORNIA ST
Practice Address - Street 2:SUITE 260
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4586
Practice Address - Country:US
Practice Address - Phone:415-921-7226
Practice Address - Fax:415-921-7225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG366472085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G366471Medicaid
CA00G366471Medicaid