Healthcare Provider Details

I. General information

NPI: 1013494426
Provider Name (Legal Business Name): DONNY MUNOZ RRT, RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 07/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9455 CLAIREMONT MESA BLVD
SAN DIEGO CA
92123-1297
US

IV. Provider business mailing address

7321 BIGNELL DR
SAN DIEGO CA
92139-1321
US

V. Phone/Fax

Practice location:
  • Phone: 858-266-4209
  • Fax:
Mailing address:
  • Phone: 619-471-4305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number31601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: