Provider Demographics
NPI:1780011270
Name:RICHARD A. MUNGER M.D.,INC.
Entity type:Organization
Organization Name:RICHARD A. MUNGER M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MUNGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-532-5154
Mailing Address - Street 1:1000 GREENLEY RD
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-5200
Mailing Address - Country:US
Mailing Address - Phone:209-536-5000
Mailing Address - Fax:
Practice Address - Street 1:650 PAULINE CT
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5210
Practice Address - Country:US
Practice Address - Phone:209-532-5154
Practice Address - Fax:209-532-5007
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SONORA REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service