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General NPI Number Information
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NPI Number | 1811121197
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Entity Type | Individual
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Provider Name | KAREN ROSA NUNEZ-WALLACE
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Gender | Female
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 19066 MAGNOLIA ST
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-2232
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Country | US
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Telephone | 714-968-0068
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | BP10034902
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | C163965
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License Number State | CA
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