Individual
FREDDIE BUNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
734 10TH AVE, SAN DIEGO, CA 92101-6502
(619) 239-4663
(619) 239-3045
Mailing address
734 10TH AVE, SAN DIEGO, CA 92101-6502
(619) 239-4663
(619) 239-3045
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
26495
CA
Other
Enumeration date
01/08/2013
Last updated
07/01/2015
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