Provider Demographics
NPI:1700901212
Name:DUNN, GREGORY Y (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:Y
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11234 ANDERSON ST
Mailing Address - Street 2:ROOM 2605
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-558-7814
Mailing Address - Fax:909-558-0202
Practice Address - Street 1:321 N KUAKINI ST
Practice Address - Street 2:ROOM 405
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2364
Practice Address - Country:US
Practice Address - Phone:808-522-0190
Practice Address - Fax:808-523-9068
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84927207R00000X, 2085R0202X
HIMD158532085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI64773701Medicaid
HIMD15853OtherQUEENS HEALTHCARE
HI990157698OtherHMAA
CA00A849270Medicaid
HI0295865OtherHMSA/HMSA QUEST
HI0429291089OtherUHA
HI1082145098OtherAETNA
HI64773702Medicaid
HI103802483OtherUS MARSHALL SVC-FED DET
HI20124380OtherUS DEPT OF LABOR
HIA0295863OtherHMSA/HMSA QUEST
HI990157698OtherHMAA
HIDT134ZMedicare PIN