MEDICARE: MUNOZ REGIMBAL AND ASSOCIATES PHYSICIANS PROFESSIONAL LLC

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	174400000X	Specialist	FX00056258	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356388276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUNOZ REGIMBAL AND ASSOCIATES PHYSICIANS PROFESSIONAL LLC

Provider Business Mailing Address
First Line	:	316 MARTIN LUTHER KING JR WAY
Second Line	:	SUITE 304
City	:	TACOMA
State	:	WA
Zip	:	98405-4252
Country	:	US
Telephone Number	:	253-272-5076
Fax Number	:	253-882-1080

Provider Business Practice Location Address
First Line	:	316 MARTIN LUTHER KING JR WAY
Second Line	:	SUITE 304
City	:	TACOMA
State	:	WA
Zip	:	98405-4252
Country	:	US
Telephone Number	:	253-272-5076
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	WINN ARCHAMBEAU-MUNOZ
Credential	:	MA
Telephone Number	:	253-272-5198

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	11/25/2009

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