Provider Demographics
NPI:1457773699
Name:R.P. DUNNUM, M.D. INC.
Entity Type:Organization
Organization Name:R.P. DUNNUM, M.D. INC.
Other - Org Name:DUNNUM OCCUPATIONAL CARE MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUNNUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-457-4717
Mailing Address - Street 1:4510 EXECUTIVE DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3021
Mailing Address - Country:US
Mailing Address - Phone:858-457-4717
Mailing Address - Fax:858-457-0470
Practice Address - Street 1:4510 EXECUTIVE DR
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3021
Practice Address - Country:US
Practice Address - Phone:858-457-4717
Practice Address - Fax:858-457-0470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG549992083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty