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General NPI Number Information
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NPI Number | 1548428097
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Entity Type | Organization
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Legal Business Name | CECILE C. DEL MUNDO, MD, PLLC
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 202 W 7TH ST STE 201
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City | LONDON
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State | KY
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Zip | 40741-1763
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Country | US
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Telephone | 606-330-0566
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Fax | 606-330-0496
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Provider Business Mailing Address
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Address Line | PO BOX 1706
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City | CORBIN
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State | KY
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Zip | 40702-1706
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Country | US
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Telephone | 606-330-0566
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Fax | 606-330-0496
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Authorized Official
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Title or Position | PRESIDENT
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Name | CECILE C. DEL MUNDO
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Credential | MD
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Telephone | 606-330-0566
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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 | 35193
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License Number State | KY
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