Provider Demographics
NPI:1508050212
Name:DUMOUCHEL, JUSTIN P (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:P
Last Name:DUMOUCHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3300 WEBSTER ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3125
Mailing Address - Country:US
Mailing Address - Phone:510-271-4400
Mailing Address - Fax:510-271-4490
Practice Address - Street 1:3300 WEBSTER ST STE 1000
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3125
Practice Address - Country:US
Practice Address - Phone:510-271-4400
Practice Address - Fax:844-852-1277
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2021-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA108411207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine