Healthcare Provider Details
I. General information
NPI: 1588960348
Provider Name (Legal Business Name): HIJINIO NUNEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/26/2011
Last Update Date: 01/26/2011
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
- Phone: 562-862-4711
- Fax: 562-622-4784
- Phone: 562-862-4711
- Fax: 562-622-4784
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1744P3200X |
| Taxonomy | Prosthetics Case Management |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: