Provider Demographics
NPI:1427195916
Name:LUNDBERG, MARK ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANDREW
Last Name:LUNDBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:202 MIRA LOMA DR
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-3500
Mailing Address - Country:US
Mailing Address - Phone:530-538-7581
Mailing Address - Fax:530-538-2165
Practice Address - Street 1:78 TABLE MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-3578
Practice Address - Country:US
Practice Address - Phone:530-538-7341
Practice Address - Fax:530-538-5294
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2008-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG644432083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine