Healthcare Provider Details

I. General information

NPI: 1902717424
Provider Name (Legal Business Name): MR. JULIO ANIBAL MUNOZ JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 E BROADWAY
LONG BEACH CA
90803-6035
US

IV. Provider business mailing address

5385 KATRINA PL
PALMDALE CA
93552-4514
US

V. Phone/Fax

Practice location:
  • Phone: 661-652-6863
  • Fax:
Mailing address:
  • Phone: 661-652-6863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: