Provider Demographics
NPI:1578601571
Name:BUNCE, ANAHITA GUIDE (MD)
Entity Type:Individual
Prefix:
First Name:ANAHITA
Middle Name:GUIDE
Last Name:BUNCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANAHITA
Other - Middle Name:
Other - Last Name:GUIDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:210 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-2517
Mailing Address - Country:US
Mailing Address - Phone:415-305-5105
Mailing Address - Fax:
Practice Address - Street 1:210 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2517
Practice Address - Country:US
Practice Address - Phone:415-305-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79739207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A797390Medicaid
CA00A797390Medicaid