Healthcare Provider Details

I. General information

NPI: 1851467609
Provider Name (Legal Business Name): RICHARD S. TUNKEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3731 SUNSET LN SUITE 102
ANTIOCH CA
94509-6127
US

IV. Provider business mailing address

3201 HILTON HEAD DR
FAIRFIELD CA
94534-7804
US

V. Phone/Fax

Practice location:
  • Phone: 707-631-1716
  • Fax:
Mailing address:
  • Phone: 707-631-1716
  • Fax: 707-428-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberG71309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: