Provider Demographics
NPI:1720347719
Name:BUNDY, LINDA MAE (APRN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MAE
Last Name:BUNDY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11386 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95946-9000
Mailing Address - Country:US
Mailing Address - Phone:530-451-6234
Mailing Address - Fax:800-603-0374
Practice Address - Street 1:11386 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95946-9000
Practice Address - Country:US
Practice Address - Phone:530-451-6234
Practice Address - Fax:800-603-0374
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA21572207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism