Provider Demographics
NPI:1356433981
Name:DUNN, MICHAEL BRENDAN (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRENDAN
Last Name:DUNN
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8823 SPECTRUM CENTER BLVD
Mailing Address - Street 2:APT #2312
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1456
Mailing Address - Country:US
Mailing Address - Phone:858-395-6042
Mailing Address - Fax:
Practice Address - Street 1:VA SAN DIEGO HEALTHCARE SYSTEM PHARMACY # 119
Practice Address - Street 2:3350 LA JOLLA VILLAGE DRIVE
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0001
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:858-552-7582
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58480183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist