MEDICARE: JAMES SANDIDGE DUNN JR MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	A84568	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124046560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES SANDIDGE DUNN JR MD INC

Provider Business Mailing Address
First Line	:	11795 EDUCATION ST
Second Line	:	SUITE 222
City	:	AUBURN
State	:	CA
Zip	:	95602-2469
Country	:	US
Telephone Number	:	530-886-6660
Fax Number	:	530-886-6656

Provider Business Practice Location Address
First Line	:	11795 EDUCATION ST
Second Line	:	SUITE 222
City	:	AUBURN
State	:	CA
Zip	:	95602-2469
Country	:	US
Telephone Number	:	530-886-6660
Fax Number	:	530-886-6656

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES S. DUNN JR.
Credential	:	M D
Telephone Number	:	530-886-6660

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	11/06/2008

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