Basic Information
| Provider Information | |||||||||
| NPI: | 1700901212 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNN | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | Y. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11234 ANDERSON ST | ||||||||
| Address2: | ROOM 2605 | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923542804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095587814 | ||||||||
| FaxNumber: | 9095580202 | ||||||||
| Practice Location | |||||||||
| Address1: | 321 N KUAKINI ST | ||||||||
| Address2: | ROOM 405 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968172364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085220190 | ||||||||
| FaxNumber: | 8085239068 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 01/18/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A84927 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2085R0202X | A84927 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | MD15853 | HI | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 64773701 | 05 | HI | MEDICAID | MD15853 | 01 | HI | QUEENS HEALTHCARE | OTHER | 990157698 | 01 | HI | HMAA | OTHER | 00A849270 | 05 | CA | MEDICAID | 0295865 | 01 | HI | HMSA/HMSA QUEST | OTHER | 0429291089 | 01 | HI | UHA | OTHER | 1082145098 | 01 | HI | AETNA | OTHER | 64773702 | 05 | HI | MEDICAID | 103802483 | 01 | HI | US MARSHALL SVC-FED DET | OTHER | 20124380 | 01 | HI | US DEPT OF LABOR | OTHER | A0295863 | 01 | HI | HMSA/HMSA QUEST | OTHER |