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General NPI Number Information
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NPI Number | 1407357114
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Entity Type | Individual
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Provider Name | JOANN MUNDIN MD, FRCPC, MSC, DABP
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Gender | Female
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 4966 EL CAMINO REAL STE 224
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City | LOS ALTOS
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State | CA
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Zip | 94022-1458
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Country | US
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Telephone | 702-613-1270
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Fax |
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Provider Business Mailing Address
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Address Line | 945 MCKINNEY ST # 19887
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City | HOUSTON
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State | TX
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Zip | 77002-6308
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Country | US
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Telephone | 702-613-1270
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 19538
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 14028A
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | AF00006
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C173941
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M-15899
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License Number State | ID
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | T3143
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License Number State | TX
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