Healthcare Provider Details

I. General information

NPI: 1790721199
Provider Name (Legal Business Name): KAZUNARI KUNO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 04/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 S UNION BLVD
COLORADO SPRINGS CO
80910
US

IV. Provider business mailing address

3205 N ACADEMY BLVD STE 130
COLORADO SPRINGS CO
80917-5152
US

V. Phone/Fax

Practice location:
  • Phone: 719-632-5700
  • Fax: 719-344-7831
Mailing address:
  • Phone: 719-632-5700
  • Fax: 719-344-7865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number199243
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0062114
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: