MEDICARE: RICHARD S. TUNKEL M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	G71309	CA

General Provider Information

NPI Number	:	1851467609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD S. TUNKEL M.D.

Provider Business Mailing Address
First Line	:	3201 HILTON HEAD DR
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-7804
Country	:	US
Telephone Number	:	707-631-1716
Fax Number	:	707-428-3770

Provider Business Practice Location Address
First Line	:	3731 SUNSET LN
Second Line	:	SUITE 102
City	:	ANTIOCH
State	:	CA
Zip	:	94509-6127
Country	:	US
Telephone Number	:	707-631-1716
Fax Number	:

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

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	07/08/2007

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