Individual provider Active NPI

Tonja Mundwiller, M.D.

  • Pediatrics Physician
  • Manhattan Beach, CA
National Provider Identifier
1306950738
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G74753 Issued in CA
Practice address
1010 N Sepulveda Blvd
Manhattan Beach, CA 90266-5929
Phone
(310) 376-6262
Fax
(310) 376-8228
NPI assigned
Aug 19, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G74753 CA
Pediatrics Physician 208000000X G74753 CA Primary

Addresses

Primary practice location

1010 N Sepulveda Blvd
Manhattan Beach, CA 90266-5929

Mailing address

1010 N Sepulveda Blvd
Manhattan Beach, CA 90266-5929
Phone (310) 376-6262

Other identifiers 1

IdentifierTypeStateIssuer
WG74753PMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G74753CAMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1306950738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665929",
            "telephone_number": "310-376-6262",
            "fax_number": "310-376-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665929",
            "telephone_number": "310-376-6262",
            "fax_number": "310-376-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDWILLER",
        "first_name": "TONJA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G74753",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G74753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WG74753P",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

Verify at the official NPI Registry.