Individual
DR. GARY WAYNE BRUNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6100 SUNRISE MALL, CITRUS HEIGHTS, CA 95610-6906
(916) 721-1466
(916) 726-0658
Mailing address
1418 PINNACLES ST, DAVIS, CA 95616-6658
(530) 759-1266
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8066T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0080660
—
CA
Enumeration date
02/07/2007
Last updated
07/08/2007
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