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NPI Code Detail

MEDICARE: JUDITH JOVIEL PUNZALAN

MEDICARE: JUDITH JOVIEL PUNZALAN
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
1363LF0000XFamily Nurse Practitioner95023316CA

General Provider Information

NPI Number : 1235845637
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH JOVIEL PUNZALAN
Provider Business Mailing Address
First Line : 23306 MARIGOLD AVE UNIT W-201
Second Line :
City : TORRANCE
State : CA
Zip : 90502-2773
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3045 E FLORENCE AVE
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-5837
Country : US
Telephone Number : 323-587-7771
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2023
Last Update Date : 01/30/2023

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