Provider Demographics
NPI:1306997564
Name:GUNSET, MARY (DC)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:GUNSET
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 MISSION CENTER COURT
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-299-5409
Mailing Address - Fax:619-299-2221
Practice Address - Street 1:7801 MISSION CENTER COURT
Practice Address - Street 2:SUITE 320
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-299-5409
Practice Address - Fax:619-299-2221
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24136111N00000X
CA#24136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24136Medicare ID - Type Unspecified
CADC24136Medicare UPIN