Individual
DR. GEORGE R KUNHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1191 E YOSEMITE AVE STE C, MANTECA, CA 95336-5071
(209) 824-2202
(209) 824-2205
Mailing address
PO BOX 1090, LODI, CA 95241-1090
(209) 334-1800
(209) 334-2416
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
40625
CA
207V00000X
Obstetrics & Gynecology Physician
DR.0037211
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01367
LICENSE
ME
01
—
MM503101
MEDICARE PTAN
ME
01
—
P00654557
RAILROAD MEDICARE
ME
Enumeration date
10/13/2006
Last updated
11/09/2020
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