1497704381 NPI number — IRENE J. BUNO-BRION M.D.

Table of content: IRENE J. BUNO-BRION M.D. (NPI 1497704381)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497704381 NPI number — IRENE J. BUNO-BRION M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUNO-BRION
Provider First Name:
IRENE
Provider Middle Name:
J.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BUNO
Provider Other First Name:
IRENE
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1497704381
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 130580
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARLSBAD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92013-0580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-710-1025
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 CRAVEN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN MARCOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92078-4201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-290-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  G83987 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207N00000X , with the licence number: MD00036768 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 159258 . This is a "LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1153BU . This is a "REGENCE BLUESHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8239014 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 070016744 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7176003 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com