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General NPI Number Information
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NPI Number | 1265745756
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Entity Type | Individual
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Provider Name | DINA MUSTAFA ALSHUNNAQ M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 26161 LA PAZ RD STE 115
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5334
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Country | US
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Telephone | 949-206-0001
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Fax | 949-206-0011
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Provider Business Mailing Address
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Address Line | 26161 LA PAZ RD STE 115
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5334
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Country | US
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Telephone | 949-206-0001
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Fax | 949-206-0011
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 56174
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | C167801
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 46105
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License Number State | KY
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