Provider Demographics
NPI:1013596683
Name:MUNDH NP & GARRETSON MD MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MUNDH NP & GARRETSON MD MEDICAL CORPORATION
Other - Org Name:FEATHER RIVER HEALTH SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NP/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNDH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-701-3131
Mailing Address - Street 1:9792 LIVE OAK BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:CA
Mailing Address - Zip Code:95953-2381
Mailing Address - Country:US
Mailing Address - Phone:530-701-3131
Mailing Address - Fax:
Practice Address - Street 1:9792 LIVE OAK BLVD STE E
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:CA
Practice Address - Zip Code:95953-2381
Practice Address - Country:US
Practice Address - Phone:530-701-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care