Provider Demographics
NPI:1336179027
Name:BUNDENS, WARNER P (MD)
Entity Type:Individual
Prefix:DR
First Name:WARNER
Middle Name:P
Last Name:BUNDENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15822 LIME GROVE RD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2112
Mailing Address - Country:US
Mailing Address - Phone:858-679-7320
Mailing Address - Fax:858-679-7390
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9001
Practice Address - Country:US
Practice Address - Phone:858-657-8630
Practice Address - Fax:619-543-3183
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28654207Q00000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G286540Medicaid
CAA43809Medicare UPIN
CA00G286540Medicaid