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General NPI Number Information
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NPI Number | 1780787283
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Entity Type | Individual
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Provider Name | ROBERTO T UNGUEZ MD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 08/17/2017
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Provider Practice Location Address
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Address Line | 164 W CARSON ST
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City | CARSON
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State | CA
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Zip | 90745-2601
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Country | US
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Telephone | 310-518-3054
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Fax | 310-835-1366
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Provider Business Mailing Address
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Address Line | 2550 PACIFIC COAST HWY #44
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City | TORRANCE
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State | CA
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Zip | 90505-7726
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Country | US
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Telephone | 310-944-5632
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G11040
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G11040
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License Number State | CA
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