MEDICARE: DR. JUDY T DEL MUNDO M.D.

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	207K00000X	Allergy & Immunology Physician	A64233	CA

General Provider Information

NPI Number	:	1942203013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDY T DEL MUNDO M.D.

Provider Business Mailing Address
First Line	:	2061 CLARMAR WAY
Second Line	:	STE A
City	:	SAN JOSE
State	:	CA
Zip	:	95128-1706
Country	:	US
Telephone Number	:	408-271-8807
Fax Number	:	408-271-9814

Provider Business Practice Location Address
First Line	:	2061 CLARMAR WAY
Second Line	:	STE A
City	:	SAN JOSE
State	:	CA
Zip	:	95128-1706
Country	:	US
Telephone Number	:	408-271-8807
Fax Number	:	408-271-9814

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/08/2007

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