Provider Demographics
NPI:1780747089
Name:BUNCH, GEORGE PARDUE (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PARDUE
Last Name:BUNCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3684
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95063-3684
Mailing Address - Country:US
Mailing Address - Phone:831-728-2969
Mailing Address - Fax:831-722-9604
Practice Address - Street 1:222 GREEN VALLEY RD
Practice Address - Street 2:PEDIATRIC MEDICAL GROUP OF WATSONVILLE
Practice Address - City:FREEDOM
Practice Address - State:CA
Practice Address - Zip Code:95019-3136
Practice Address - Country:US
Practice Address - Phone:831-728-2969
Practice Address - Fax:831-722-9604
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM7118208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM49395Medicaid
NM49395Medicaid