Provider Demographics
NPI:1861514085
Name:KUNTZ, WILLIAM DARRELL (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DARRELL
Last Name:KUNTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4336 POSEIDON LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4155
Mailing Address - Country:US
Mailing Address - Phone:916-900-4249
Mailing Address - Fax:916-900-4249
Practice Address - Street 1:4336 POSEIDON LN
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4155
Practice Address - Country:US
Practice Address - Phone:916-900-4249
Practice Address - Fax:916-900-4249
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC31838207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA-34731Medicare UPIN