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General NPI Number Information
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NPI Number | 1306939749
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Entity Type | Organization
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Legal Business Name | BUNNAUN UCH
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Dates
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Enumeration Date | 09/30/2006
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 4555 N PERSHING AVE STE 7
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City | STOCKTON
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State | CA
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Zip | 95207-6740
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Country | US
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Telephone | 209-888-2099
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Fax | 209-888-2105
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Provider Business Mailing Address
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Address Line | 4555 N PERSHING AVE STE 7
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City | STOCKTON
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State | CA
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Zip | 95207-6740
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Country | US
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Telephone | 209-473-4706
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Fax | 209-473-7377
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Authorized Official
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Title or Position | OWNER/PIC
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Name | BUNNAUN UCH
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Credential |
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Telephone | 209-888-2099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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