Provider Demographics
NPI:1962467258
Name:PUNIM, JEFFREY A (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:PUNIM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:17822 BEACH BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7101
Mailing Address - Country:US
Mailing Address - Phone:714-842-9500
Mailing Address - Fax:714-841-0760
Practice Address - Street 1:17822 BEACH BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7101
Practice Address - Country:US
Practice Address - Phone:714-842-9500
Practice Address - Fax:714-841-0760
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2008-05-09
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Provider Licenses
StateLicense IDTaxonomies
CAG41751207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
A92285Medicare UPIN