Healthcare Provider Details

I. General information

NPI: 1124046560
Provider Name (Legal Business Name): JAMES SANDIDGE DUNN JR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 11/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11795 EDUCATION ST SUITE 222
AUBURN CA
95602-2469
US

IV. Provider business mailing address

11795 EDUCATION ST SUITE 222
AUBURN CA
95602-2469
US

V. Phone/Fax

Practice location:
  • Phone: 530-886-6660
  • Fax: 530-886-6656
Mailing address:
  • Phone: 530-886-6660
  • Fax: 530-886-6656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA84568
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES S. DUNN JR.
Title or Position: PRESIDENT
Credential: M D
Phone: 530-886-6660