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General NPI Number Information
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NPI Number | 1497225106
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Entity Type | Individual
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Provider Name | MICHAEL NAZARENO
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Gender | Male
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Dates
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Enumeration Date | 11/26/2018
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 2510 EL CAMINO REAL
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City | CARLSBAD
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State | CA
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Zip | 92008-1273
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Country | US
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Telephone | 949-364-2900
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Fax | 949-365-0117
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Provider Business Mailing Address
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Address Line | 2510 EL CAMINO REAL
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City | CARLSBAD
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State | CA
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Zip | 92008-1273
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Country | US
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Telephone | 949-364-2900
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Fax | 949-365-0117
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95033607
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License Number State | CA
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