Healthcare Provider Details

I. General information

NPI: 1992044374
Provider Name (Legal Business Name): JEFFREY SHERIDAN DUNHAM M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 02/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 N SUNRISE WAY SUITE E
PALM SPRINGS CA
92262-3408
US

IV. Provider business mailing address

1751 N SUNRISE WAY SUITE E
PALM SPRINGS CA
92262-3408
US

V. Phone/Fax

Practice location:
  • Phone: 760-327-2277
  • Fax: 760-325-4031
Mailing address:
  • Phone: 760-327-2277
  • Fax: 760-325-4031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberG53524
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: