Provider Demographics
NPI:1558566968
Name:BUNCH, RAYMOND (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:BUNCH
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 1:3951 S PLAZA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7461
Mailing Address - Country:US
Mailing Address - Phone:714-751-8570
Mailing Address - Fax:
Practice Address - Street 1:3951 S PLAZA DR STE 150
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7461
Practice Address - Country:US
Practice Address - Phone:714-751-8570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA54220DC0209290OtherBLUE SHIELD
CADC20929OtherLICENSE #