Provider Demographics
NPI:1003079062
Name:MUNDI, JAGMEET S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAGMEET
Middle Name:S
Last Name:MUNDI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:26726 CROWN VALLEY PKWY
Mailing Address - Street 2:#200
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8003
Mailing Address - Country:US
Mailing Address - Phone:949-364-4361
Mailing Address - Fax:949-364-4495
Practice Address - Street 1:26726 CROWN VALLEY PKWY
Practice Address - Street 2:#200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8003
Practice Address - Country:US
Practice Address - Phone:949-364-4361
Practice Address - Fax:949-364-4495
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA107865207Y00000X, 174400000X
NY264655207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology