Provider Demographics
NPI:1073623278
Name:MUNISH LAL MD, INC, PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MUNISH LAL MD, INC, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-891-0325
Mailing Address - Street 1:274 COHASSET RD
Mailing Address - Street 2:STE 110
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2236
Mailing Address - Country:US
Mailing Address - Phone:530-891-0325
Mailing Address - Fax:530-895-0784
Practice Address - Street 1:274 COHASSET RD
Practice Address - Street 2:STE 110
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2236
Practice Address - Country:US
Practice Address - Phone:530-891-0325
Practice Address - Fax:530-895-0784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85179207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI11587Medicare UPIN