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Individual

RUDOLF FABIAN BUNTIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
45 CASTRO ST, STE 121, SAN FRANCISCO, CA 94114-1010
(415) 565-6136
(415) 864-1654
Mailing address
45 CASTRO ST, SUITE 121, SAN FRANCISCO, CA 94114-1010
(415) 565-6136
(415) 864-1654

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
G74250
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G742500
BLUE SHIELD
CA
05
00G742500
CA
Enumeration date
10/24/2005
Last updated
10/17/2008
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