Healthcare Provider Details

I. General information

NPI: 1023266004
Provider Name (Legal Business Name): BEN BUNYI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD BLDG 400
SALINAS CA
93906-3100
US

IV. Provider business mailing address

1441 CONSTITUTION BLVD BLDG 400, SUITE 202
SALINAS CA
93906-3100
US

V. Phone/Fax

Practice location:
  • Phone: 831-796-1700
  • Fax:
Mailing address:
  • Phone: 831-796-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF 48960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: