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General NPI Number Information
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NPI Number | 1467681247
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Entity Type | Organization
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Legal Business Name | HARVINDER MUNDH MD CORPORATION
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 4000 CIVIC CENTER DR STE 205
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City | SAN RAFAEL
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State | CA
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Zip | 94903-5233
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Country | US
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Telephone | 415-492-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 2271 ABBY RD
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City | ROCKLIN
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State | CA
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Zip | 95765-4621
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Country | US
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Telephone | 916-295-9726
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. HARVINDER MUNDH
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Credential | M.D.
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Telephone | 916-295-9726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A89296
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | A89296
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License Number State | CA
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