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NPI Code Detail

MEDICARE: MARC BRUNTON RN

MEDICARE:   MARC  BRUNTON  RN
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
1163W00000XRegistered Nurse707293CA

General Provider Information

NPI Number : 1871678474
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARC BRUNTON RN
Provider Business Mailing Address
First Line : PO BOX 67
Second Line :
City : BONITA
State : CA
Zip : 91908-0067
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 892 27TH ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92154-1444
Country : US
Telephone Number : 619-575-4687
Fax Number : 619-575-1215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 06/12/2021

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Directions to “ MARC BRUNTON RN” Practice Location

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