Russell Bunting, PTA
Individual provider Active NPI Physical Therapy Assistant · Turlock, CA
NPI 1275360232 · NPPES record last updated Sep 16, 2024
Key facts
- NPI
- 1275360232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 53045 (CA)
- Practice address
- 1101 E Tuolumne Rd
Turlock, CA 95382-1541 - Phone
- (209) 667-8409
- NPI assigned
- Sep 16, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53045 | CA | MD | Physical Therapy Assistant |
| 2181592 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Care California, LLC | Current |
Accepting new patients |
Locations
1101 E Tuolumne Rd
Turlock, CA 95382
Phone (209) 632-7577
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2181592 | TX | |
| Physical Therapy Assistant | 225200000X | 53045 | CA | Yes |
Addresses
Primary practice location
1101 E Tuolumne Rd
Turlock, CA 95382-1541
Mailing address
PO Box 342
Kingsburg, CA 93631-0342
Other providers in Turlock, CA
- Bryan L Green
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- Karla Sofia Buenrostro
- Shantelle Noel Buethe
- Hiep P Bui
- Arik Burgin
- Sheree Burleson
- Kaila Meridian Burnett
- Ian McVay Burroughs
- Belen Carolina Bustos Munoz
All providers in Turlock, CA · Physical Therapy Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.