MEDICARE: MS. MARILYN DORMUBARI SUNDAY RN

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	163WC1500X	Community Health Registered Nurse	95032926	CA

General Provider Information

NPI Number	:	1497361430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARILYN DORMUBARI SUNDAY RN

Provider Business Mailing Address
First Line	:	7511 CLEAR LAKE ALY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95829-8743
Country	:	US
Telephone Number	:	916-664-7684
Fax Number	:

Provider Business Practice Location Address
First Line	:	7511 CLEAR LAKE ALY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95829-8743
Country	:	US
Telephone Number	:	916-664-7684
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	09/16/2020

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