Provider Demographics
NPI:1336181858
Name:PUND, ERNEST E JR (MD)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:E
Last Name:PUND
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1796 LA JOLLA RANCHO RD
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7847
Mailing Address - Country:US
Mailing Address - Phone:858-459-6305
Mailing Address - Fax:858-454-4603
Practice Address - Street 1:1796 LA JOLLA RANCHO RD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-7847
Practice Address - Country:US
Practice Address - Phone:858-459-6305
Practice Address - Fax:858-454-4603
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC24202207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A48411Medicare UPIN