Provider Demographics
NPI:1659910404
Name:LUNSFORD, JAMES (REGISTERED NURSE)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:LUNSFORD
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4327 DALTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90062-1813
Mailing Address - Country:US
Mailing Address - Phone:323-377-3725
Mailing Address - Fax:
Practice Address - Street 1:4327 DALTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90062-1813
Practice Address - Country:US
Practice Address - Phone:323-377-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA737231163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice