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General NPI Number Information
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NPI Number | 1831530872
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Entity Type | Individual
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Provider Name | WILLARD DOUGLAS KUNZ DVM
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Gender | Male
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Dates
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Enumeration Date | 07/06/2013
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Last Update Date | 07/06/2013
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Provider Practice Location Address
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Address Line | 4299 E RAMON RD
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City | PALM SPRINGS
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State | CA
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Zip | 92264-1422
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Country | US
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Telephone | 760-778-9999
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Fax | 760-778-9979
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Provider Business Mailing Address
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Address Line | 4299 E RAMON RD
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City | PALM SPRINGS
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State | CA
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Zip | 92264-1422
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Country | US
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Telephone | 760-778-9999
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Fax | 760-778-9979
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 6312
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | V-1114
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 6694020-2801
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License Number State | UT
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