Basic Information
| Provider Information | |||||||||
| NPI: | 1053382085 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUNCIR | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7261 MERCY RD | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681242311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023986248 | ||||||||
| FaxNumber: | 4028298513 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 CITY BLVD W | ||||||||
| Address2: | SUITE 1600 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928682903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144565890 | ||||||||
| FaxNumber: | 7144566048 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2006 | ||||||||
| LastUpdateDate: | 10/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0102X | G072181 | CA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | G072181 | CA | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | G072181 | CA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.