Individual provider Active NPI

Scott Patrick Bunner, M.D.

  • Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1720115090
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G083336 Issued in CA
Practice address
1250 Morena Blvd
San Diego, CA 92110-3815
Phone
(619) 692-8752
Fax
(619) 692-8779
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G083336 CA Primary

Addresses

Primary practice location

1250 Morena Blvd
San Diego, CA 92110-3815

Mailing address

1250 Morena Blvd
San Diego, CA 92110-3815
Phone (619) 692-8752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090730000518 CA Practitioner - Psychiatry 0547313025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Toledo College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San DiegoGroup PAC ID 8123014057, 17 clinicians

Practice addresses (Care Compare)

1250 Morena Blvd
San Diego, CA 92110-3815
Phone (619) 692-8750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
83336CAMDPharmacist
G083336CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Diego Current Accepting new patients
County of San Diego CurrentSince Oct 20, 2015 Accepting new patients
County of San Diego CurrentSince Oct 20, 2015 Accepting new patients

Locations

1000 Broadway
Ste 210
El Cajon, CA 92021
Phone (619) 401-5500

1250 Morena Blvd
San Diego, CA 92110
Phone (619) 692-8715

3853 Rosecrans St
San Diego, CA 92110
Phone (619) 615-0439

3177 Ocean View Blvd
San Diego, CA 92113
Phone (619) 231-9300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1720115090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 MORENA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103815",
            "telephone_number": "619-692-8752",
            "fax_number": "619-692-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MORENA BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103815",
            "telephone_number": "619-692-8752",
            "fax_number": "619-692-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNNER",
        "first_name": "SCOTT",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G083336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.