Healthcare Provider Details

I. General information

NPI: 1821279308
Provider Name (Legal Business Name): CRAIG M. RUNDBAKEN, D.O. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 W GRANITE VALLEY DR STE E23
SUN CITY WEST AZ
85375-5798
US

IV. Provider business mailing address

14300 W GRANITE VALLEY DR STE E23
SUN CITY WEST AZ
85375-5798
US

V. Phone/Fax

Practice location:
  • Phone: 623-975-0500
  • Fax: 623-975-0705
Mailing address:
  • Phone: 623-975-0500
  • Fax: 623-975-0705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: CLAY W SPENCE
Title or Position: ADMINISTRATOR
Credential:
Phone: 623-975-0500