Healthcare Provider Details

I. General information

NPI: 1366620015
Provider Name (Legal Business Name): FERNANDO J NUNEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 03/07/2008
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 Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: FERNANDO JOSE NUNEZ
Title or Position: OWNER
Credential: C.P.
Phone: 562-862-4711