Healthcare Provider Details

I. General information

NPI: 1023178803
Provider Name (Legal Business Name): FERNANDO JOSE NUNEZ CP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9102 FIRESTONE BLVD SUITE E
DOWNEY CA
90241-5348
US

IV. Provider business mailing address

9102 FIRESTONE BLVD SUITE E
DOWNEY CA
90241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 562-862-4711
  • Fax: 562-862-4711
Mailing address:
  • Phone: 562-862-4711
  • Fax: 562-862-4711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: