Healthcare Provider Details

I. General information

NPI: 1386108090
Provider Name (Legal Business Name): BRYAN MITCHEL HUNT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 FAIRMOUNT AVE STE 2B
EL CERRITO CA
94530-3623
US

IV. Provider business mailing address

6500 FAIRMOUNT AVE STE 2B
EL CERRITO CA
94530-3623
US

V. Phone/Fax

Practice location:
  • Phone: 510-722-0407
  • Fax: 510-722-0419
Mailing address:
  • Phone: 714-222-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number80201
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: