Healthcare Provider Details

I. General information

NPI: 1700790102
Provider Name (Legal Business Name): DANTE JAMONE MURRY II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 3RD ST
RAMONA CA
92065-2406
US

IV. Provider business mailing address

500 3RD ST
RAMONA CA
92065-2406
US

V. Phone/Fax

Practice location:
  • Phone: 760-789-7299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN751337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: