MEDICARE: HARDEEP MUNDH

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	363LF0000X	Family Nurse Practitioner	95009874	CA

General Provider Information

NPI Number	:	1982186508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARDEEP MUNDH

Provider Business Mailing Address
First Line	:	9792 LIVE OAK BLVD STE E
Second Line	:
City	:	LIVE OAK
State	:	CA
Zip	:	95953-2381
Country	:	US
Telephone Number	:	530-701-3131
Fax Number	:	530-237-0460

Provider Business Practice Location Address
First Line	:	9792 LIVE OAK BLVD STE E
Second Line	:
City	:	LIVE OAK
State	:	CA
Zip	:	95953-2381
Country	:	US
Telephone Number	:	530-701-3131
Fax Number	:	530-237-0460

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

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	12/19/2022

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Directions to “ HARDEEP MUNDH ” Practice Location

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