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NPI Code Detail

MEDICARE: MICHAEL ANTHONY NUNEZ

MEDICARE: MICHAEL ANTHONY NUNEZ
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
1101YA0400XAddiction (Substance Use Disorder) Counselor9426CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1370003ANOTHERCASTATE ISSUED LICENSE

General Provider Information

NPI Number : 1265083299
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ANTHONY NUNEZ
Provider Business Mailing Address
First Line : 5855 STREAMVIEW DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92105-3910
Country : US
Telephone Number : 619-287-5460
Fax Number : 619-287-5040
Provider Business Practice Location Address
First Line : 5855 STREAMVIEW DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92105-3910
Country : US
Telephone Number : 619-287-5460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2019
Last Update Date : 09/20/2019

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