Individual
DR. BLANCA BISUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 PEACH STREET, SUITE A, SAN LUIS OBISPO, CA 93401-2837
(805) 543-4043
(805) 543-7640
Mailing address
117 WEST BUNNY AVENUE, SANTA MARIA, CA 93458-2805
(805) 543-4043
(805) 543-7640
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A125110
CA
207Q00000X
Family Medicine Physician
Primary
A125110
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB234677
MEDICARE ID
CA
Enumeration date
09/10/2009
Last updated
10/15/2021
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