Provider Demographics
NPI:1528405339
Name:BUNN, LYNDA SUZANNE (DC)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:SUZANNE
Last Name:BUNN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:591 REDWOOD HWY FRONTAGE RD
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-6001
Mailing Address - Country:US
Mailing Address - Phone:415-314-0676
Mailing Address - Fax:415-389-7912
Practice Address - Street 1:591 REDWOOD HWY FRONTAGE RD
Practice Address - Street 2:SUITE 2300
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-6001
Practice Address - Country:US
Practice Address - Phone:415-314-0676
Practice Address - Fax:415-389-7912
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor