Provider Demographics
NPI:1831079102
Name:BRUNKER, DANIEL ALLEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALLEN
Last Name:BRUNKER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 N EL CAMINO REAL # B351
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1334
Mailing Address - Country:US
Mailing Address - Phone:760-652-5236
Mailing Address - Fax:
Practice Address - Street 1:3257 CAMINO DE LOS COCHES STE 301
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8974
Practice Address - Country:US
Practice Address - Phone:760-652-5236
Practice Address - Fax:760-652-5134
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist