Healthcare Provider Details

I. General information

NPI: 1073623278
Provider Name (Legal Business Name): MUNISH LAL MD, INC, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 COHASSET RD STE 110
CHICO CA
95926-2236
US

IV. Provider business mailing address

274 COHASSET RD STE 110
CHICO CA
95926-2236
US

V. Phone/Fax

Practice location:
  • Phone: 530-891-0325
  • Fax: 530-895-0784
Mailing address:
  • Phone: 530-891-0325
  • Fax: 530-895-0784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA85179
License Number StateCA

VIII. Authorized Official

Name: MRS. MELANIE A DODD
Title or Position: OFFICE MANAGER
Credential:
Phone: 530-891-0325