Provider Demographics
NPI:1558430934
Name:BUNGANICH, DAVID WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:BUNGANICH
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 1:166 COHASSET RD
Mailing Address - Street 2:STE. 6
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2247
Mailing Address - Country:US
Mailing Address - Phone:530-894-7261
Mailing Address - Fax:530-894-8561
Practice Address - Street 1:166 COHASSET RD
Practice Address - Street 2:STE. 6
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2247
Practice Address - Country:US
Practice Address - Phone:530-894-7261
Practice Address - Fax:530-894-8561
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0180570111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0180570OtherCHIROPRACTIC LICENSE
CADC0180570OtherCHIROPRACTIC LICENSE