Provider Demographics
NPI:1215074794
Name:GUNDERSON, JOHN PIERCE (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PIERCE
Last Name:GUNDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 GALAXY CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4933
Mailing Address - Country:US
Mailing Address - Phone:925-685-7744
Mailing Address - Fax:925-685-0462
Practice Address - Street 1:2231 GALAXY CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4933
Practice Address - Country:US
Practice Address - Phone:925-685-7744
Practice Address - Fax:925-685-0462
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC0325892083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine