MEDICARE: SCOTT BRUNNER MD

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	207Q00000X	Family Medicine Physician	G57856	CA

General Provider Information

NPI Number	:	1538188529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT BRUNNER MD

Provider Business Mailing Address
First Line	:	11 TECHNOLOGY DR
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-2302
Country	:	US
Telephone Number	:	949-923-3488
Fax Number	:	855-812-5865

Provider Business Practice Location Address
First Line	:	10601 WALKER ST
Second Line	:	SUITE 250
City	:	CYPRESS
State	:	CA
Zip	:	90630-4733
Country	:	US
Telephone Number	:	714-252-8311
Fax Number	:	714-252-8339

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/19/2015

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Directions to “ SCOTT BRUNNER MD” Practice Location

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