Mary Bunzel, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1092 Issued in CA

Practice address

500 San Pablo Ave
Albany, CA 94706-1103

Phone

(510) 204-8130

Fax

(510) 524-0861

NPI assigned

Oct 4, 2006

Last updated

Oct 30, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1164517850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SAN PABLO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061103",
            "telephone_number": "510-204-8130",
            "fax_number": "510-524-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SAN PABLO AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947061103",
            "telephone_number": "510-204-8130",
            "fax_number": "510-524-0861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 San Pablo Ave",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "CA",
            "postal_code": "947061127",
            "country_code": "US",
            "telephone_number": "510-524-9247",
            "fax_number": "510-524-0861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNZEL",
        "first_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "10692",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "1092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• California Sports Physical Therapy Centers Inc (Albany Physical Therapy)

• Family Nurse Practitioner in Albany, CA
• Providers in Albany, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.