MEDICARE: HERIBERTO NUNEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A79979	CA
2	207QA0505X	Adult Medicine Physician	A79979	CA
3	207QG0300X	Geriatric Medicine (Family Medicine) Physician	A79979	CA
4	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	A79979	CA
5	208D00000X	General Practice Physician	A79979	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A79979	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1164692703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERIBERTO NUNEZ M.D.

Provider Business Mailing Address
First Line	:	850 S ATLANTIC BLVD STE 203
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-6707
Country	:	US
Telephone Number	:	626-284-3111
Fax Number	:	626-872-2450

Provider Business Practice Location Address
First Line	:	850 S ATLANTIC BLVD STE 203
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-6707
Country	:	US
Telephone Number	:	626-284-3111
Fax Number	:	626-872-2450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	03/04/2020

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Directions to “ HERIBERTO NUNEZ M.D.” Practice Location

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