Active NPI
Richard D Brunner
- Specialist
- Sacramento, CA
National Provider Identifier
1619393394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- CP2801
- Practice address
- 1248 32ND St
Sacramento, CA 95816-5210 - Phone
- (916) 452-5724
- NPI assigned
- Mar 5, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | CP2801 | CA | Primary |
Addresses
Primary practice location
1248 32ND St
Sacramento, CA 95816-5210
Mailing address
1820 Atwell St
Roseville, CA 95747-4937
Phone (916) 216-1435
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CP2801 | Other | AMERICAN BOARD OF CERTIFICATION (ABC) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP2801 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393977600000",
"number": "1619393394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 ATWELL ST",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "957474937",
"telephone_number": "916-216-1435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1248 32ND ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165210",
"telephone_number": "916-452-5724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNNER",
"first_name": "RICHARD",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-05",
"last_updated": "2014-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "CP2801",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN BOARD OF CERTIFICATION (ABC)",
"identifier": "CP2801",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.