Organization
BUNCKE MEDICAL CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY M. BUNCKE (OWNER)
(415) 565-6136
Entity
Organization
Contact information
Practice address
45 CASTRO ST., #121, SAN FRANCISCO, CA 94114-1010
(415) 565-6136
(415) 864-1654
Mailing address
45 CASTRO ST., #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
35001
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0046560
—
CA
Enumeration date
10/24/2005
Last updated
05/03/2011
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