Patricia M Lundeberg, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

G56317 Issued in CA

Practice address

2001 4TH Ave
San Diego, CA 92101-2303

Phone

(858) 499-2777

NPI assigned

Oct 4, 2006

Last updated

Oct 25, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1982799888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012303",
            "telephone_number": "858-499-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012303",
            "telephone_number": "858-499-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDEBERG",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G56317",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "G56317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G563170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Lundbohm, BCBA
• Dana Jo Lunde, NNP
• Dillon Lunde
• Ottar Viker Lunde, M.D.
• Holly Lundeberg
• Kalle Ellen Lunden, NP
• Debora Lundgren-Walls, CNM
• Daniel John Lundgren, P.T.
• Chase Lundin
• Katarina Lundin, DACM L.AC.

• Geriatric Medicine (Family Medicine) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Geriatric Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.