MR. RUSSELL PAUL DUNNUM (NPI# 1396856290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396856290 |
| Entity Type | Individual |
| Full Name | MR. RUSSELL PAUL DUNNUM |
| Credential | M.D. |
| Practice Address |
4510 Executive Dr Suite 107 San Diego CA 92121-3021 |
| Practice Telephone | 8584574717 |
| Practice Fax Number | 8584570470 |
| Mailing Telephone | 8584574717 |
| Mailing Fax Number | 8584570470 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-08-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | G54999 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | OOG549990 | 05 |
| Street Address |
4510 EXECUTIVE DR SUITE 107 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-3021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538153747 | James Raymond Moitoza | Orthopaedic Surgery | 4510 Executive Dr, Suite 125, San Diego, CA 92121-3021 | 2005-09-01 |
| 1255999736 | Chelsea Vanderwoude | Student in an Organized Health Care Education/Training Program | 4510 Executive Dr, San Diego, CA 92121-3021 | 2019-05-30 |
| 1164959433 | Keri Anne O'connor | Registered Nurse | 4510 Executive Dr, San Diego, CA 92121-3021 | 2017-05-17 |
| 1891230868 | Kaizen Brain Center | Psychiatry & Neurology | 4510 Executive Dr, Suite 107, San Diego, CA 92121-3021 | 2016-12-30 |
| 1285179614 | Hatem Abou-sayed Md Mba Facs - A Professional Medical Corporation | Plastic Surgery | 4510 Executive Dr, Suite 105, San Diego, CA 92121-3021 | 2016-12-20 |
| 1508310319 | Ana Ramirez | Psychologist | 4510 Executive Dr, Suite 315, San Diego, CA 92121-3021 | 2016-08-09 |
| 1457711657 | Achieve Tms Centers, LLC | Psychiatry & Neurology | 4510 Executive Dr, 115, San Diego, CA 92121-3021 | 2016-03-01 |
| 1932501640 | K Kohani D D S A Professional Corporation | Dentist | 4510 Executive Dr, Suite 205, San Diego, CA 92121-3021 | 2014-09-24 |
| 1306263470 | Eric Lamarca | Radiologic Technologist | 4510 Executive Dr, Suite 125, San Diego, CA 92121-3021 | 2014-03-26 |
| 1902220809 | Shashita Inamdar Md Professional Corporation | Psychiatry & Neurology | 4510 Executive Dr, Ste 115, San Diego, CA 92121-3021 | 2014-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| 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. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541463 | Serena Mink | Specialist | 100 Park Plz Apt 407, San Diego, CA 92101-6710 | 2020-06-02 |
| 1023648201 | Pamela Renea Crane | Specialist | 3237 Meade Ave, San Diego, CA 92116-4519 | 2020-01-16 |
| 1184199853 | Oliver Rakeem Taylor | Specialist | 1265 Angelus Ave, San Diego, CA 92114-3108 | 2018-10-09 |
| 1376040923 | Mark Edmond Rierson | Specialist | 2333 1st Ave Ste 106, San Diego, CA 92101-1538 | 2018-04-10 |
| 1790232635 | Cristina Zheng-castruita | Specialist | 9308 Babauta Rd, Apt. 62, San Diego, CA 92129-4922 | 2016-09-08 |
| 1689027955 | Neelam Agashe | Specialist | 3445 Lebon Dr Apt 1215, San Diego, CA 92122-5267 | 2016-07-21 |
| 1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
| 1952765935 | Jacqueline Morgan | Specialist | 9625 Black Mountain Rd Ste 300, San Diego, CA 92126-4598 | 2016-04-06 |
| 1710341862 | Comprehensive Medical Reporting Services | Specialist | 9040 Friars Rd., Ste. 410, San Diego, CA 92108 | 2016-04-05 |
| 1790150555 | Mahmood Nazari | Specialist | 6209 Lake Apopka Pl, 6209 Lake Apopka Place, San Diego, CA 92119-3520 | 2015-12-04 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.