MEDICARE: APRIL CHARMAINE PUNSAL GACUYA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	95015010	CA

General Provider Information

NPI Number	:	1609518489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APRIL CHARMAINE PUNSAL GACUYA NP

Provider Business Mailing Address
First Line	:	110 W STOCKER ST
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2509
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 W STOCKER ST
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2509
Country	:	US
Telephone Number	:	818-244-7237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2022
Last Update Date	:	04/11/2022

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