=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124046560
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES SANDIDGE DUNN JR MD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2006
-----------------------------------------------------
Last Update Date | 11/06/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11795 EDUCATION ST SUITE 222
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95602-2469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-886-6660
-----------------------------------------------------
Fax | 530-886-6656
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11795 EDUCATION ST SUITE 222
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95602-2469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-886-6660
-----------------------------------------------------
Fax | 530-886-6656
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JAMES S. DUNN JR.
-----------------------------------------------------
Credential | M D
-----------------------------------------------------
Telephone | 530-886-6660
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | A84568
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------