Healthcare Provider Details

I. General information

NPI: 1912820796
Provider Name (Legal Business Name): ALLEN NUNOKAWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 N COLLEGE WAY
CLAREMONT CA
91711-3944
US

IV. Provider business mailing address

1559 WEBSTER AVE
CLAREMONT CA
91711-3580
US

V. Phone/Fax

Practice location:
  • Phone: 909-621-8222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number95109754
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: