Provider Demographics
NPI:1851439541
Name:KUNZMAN, SANDRA C (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:C
Last Name:KUNZMAN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:655 N ALVERNON WAY
Mailing Address - Street 2:216
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1823
Mailing Address - Country:US
Mailing Address - Phone:520-327-0460
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:5880 N LA CHOLLA BLVD
Practice Address - Street 2:STE 150
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3593
Practice Address - Country:US
Practice Address - Phone:520-751-3602
Practice Address - Fax:520-547-5761
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZ2994363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S47164Medicare UPIN