Provider Demographics
NPI:1669702023
Name:MUNGCAL, RODOMELLE C (MD)
Entity type:Individual
Prefix:
First Name:RODOMELLE
Middle Name:C
Last Name:MUNGCAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18564 US HIGHWAY 18 STE 105
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2320
Mailing Address - Country:US
Mailing Address - Phone:760-242-7777
Mailing Address - Fax:760-242-2658
Practice Address - Street 1:13010 HESPERIA RD STE 300
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8315
Practice Address - Country:US
Practice Address - Phone:760-843-7813
Practice Address - Fax:760-843-7831
Is Sole Proprietor?:No
Enumeration Date:2010-01-07
Last Update Date:2012-12-28
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Provider Licenses
StateLicense IDTaxonomies
CAA110662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine