Provider Demographics
NPI:1871721340
Name:GUNDERSON, CRAIG DUANE (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:DUANE
Last Name:GUNDERSON
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 ANGIE CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-9271
Mailing Address - Country:US
Mailing Address - Phone:661-861-1000
Mailing Address - Fax:661-587-5826
Practice Address - Street 1:9450 MING AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-1388
Practice Address - Country:US
Practice Address - Phone:661-861-1000
Practice Address - Fax:661-587-5826
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11739111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT04471Medicare UPIN
CADCO117390Medicare PIN