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Organization
NISHA BUNKE, MD
Active
Organization
NISHA BUNKE, MD
Active
Other names
La Jolla Vein Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NISHA JANAYA BUNKE MD (OWNER)
(858) 550-0330
Entity
Organization
Contact information
Practice address
9850 GENESEE AVE, SUITE 410, LA JOLLA, CA 92037-1224
(858) 550-0330
(858) 550-0676
Mailing address
9850 GENESEE AVE, SUITE 410, LA JOLLA, CA 92037-1224
(858) 550-0330
(858) 550-0676
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A101022
STATE LICENSE NUMBER
CA
Enumeration date
03/29/2011
Last updated
06/25/2020
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