MEDICARE: KAITLYNN HUNKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	15198	CA

General Provider Information

NPI Number	:	1265811632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYNN HUNKER

Provider Business Mailing Address
First Line	:	11160 WASHINGTON BLVD
Second Line	:	SUITE A
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3977
Country	:	US
Telephone Number	:	310-425-8092
Fax Number	:

Provider Business Practice Location Address
First Line	:	11160 WASHINGTON BLVD
Second Line	:	SUITE A
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3977
Country	:	US
Telephone Number	:	310-425-8092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2015
Last Update Date	:	05/19/2015

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Directions to “ KAITLYNN HUNKER ” Practice Location

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