Healthcare Provider Details

I. General information

NPI: 1124062500
Provider Name (Legal Business Name): JOHN J HUNTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 SONOMA AVE STE 2
SANTA ROSA CA
95404-4813
US

IV. Provider business mailing address

990 SONOMA AVE STE 2
SANTA ROSA CA
95404-4813
US

V. Phone/Fax

Practice location:
  • Phone: 707-527-8444
  • Fax: 707-527-5327
Mailing address:
  • Phone: 707-527-5155
  • Fax: 707-527-1071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG57697
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: