MR. RUSSELL PAUL DUNNUM M.D. NPI 1396856290

NPI Information

NPI: 1396856290
Provider Name: MR. RUSSELL PAUL DUNNUM, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
4510 EXECUTIVE DR
SUITE 107
SAN DIEGO, CA
ZIP 92121
Phone: (858) 457-4717
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MR. Russell Paul Dunnum, M.D. is a specialist in San Diego, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MR. Russell Paul Dunnum, M.D. NPI is 1396856290. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4510 EXECUTIVE DR
SUITE 107
SAN DIEGO, CA
ZIP 92121-021
Phone: (858) 457-4717
Fax: (858) 457-0470

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/5/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		G54999	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	OOG549990	MEDICAID	CALIFORNIA
2	BDG5499	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
3	B57973	MEDICARE UPIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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