Provider Demographics
NPI:1386108090
Name:HUNT, BRYAN MITCHEL (PHARMD)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:MITCHEL
Last Name:HUNT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 45TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-3331
Mailing Address - Country:US
Mailing Address - Phone:714-222-3600
Mailing Address - Fax:
Practice Address - Street 1:300 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-1902
Practice Address - Country:US
Practice Address - Phone:415-788-2984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-27
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist