MEDICARE: DR. ERWIN BAUTISTA SUNGA OD

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	152W00000X	Optometrist	36308	CA

General Provider Information

NPI Number	:	1730014796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERWIN BAUTISTA SUNGA OD

Provider Business Mailing Address
First Line	:	200 MINOR HALL
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94720-0001
Country	:	US
Telephone Number	:	510-642-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 MINOR HALL
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94720-0001
Country	:	US
Telephone Number	:	510-642-2020
Fax Number	:

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

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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