Provider Demographics
NPI:1346295904
Name:MUNSON, JAMES L (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:MUNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:245 TERRACINA BLVD
Mailing Address - Street 2:209C
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4852
Mailing Address - Country:US
Mailing Address - Phone:909-793-2999
Mailing Address - Fax:909-793-3370
Practice Address - Street 1:245 TERRACINA BLVD
Practice Address - Street 2:209C
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4852
Practice Address - Country:US
Practice Address - Phone:909-793-2999
Practice Address - Fax:909-793-3370
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG39025207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G390250Medicare PIN