Individual
KOICHI SHUN KUNITAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1145 STURGIS RD, TWENTYNINE PALMS, CA 92278
(760) 830-2722
Mailing address
3525 DEL MAR HEIGHTS RD # 1987, SAN DIEGO, CA 92130-2199
(858) 245-2353
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
118976
CA
Other
Enumeration date
07/10/2008
Last updated
07/26/2024
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