Healthcare Provider Details

I. General information

NPI: 1013160563
Provider Name (Legal Business Name): PAMELA LANDSTEINER MUNDELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SIERRA PARK RD
MAMMOTH LAKES CA
93546-2073
US

IV. Provider business mailing address

85 SIERRA PARK RD
MAMMOTH LAKES CA
93546-2073
US

V. Phone/Fax

Practice location:
  • Phone: 760-934-3311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA105863
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: