MEDICARE: DR. HARRY EDMOND NERVINO MD

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	207R00000X	Internal Medicine Physician	A36694	CA

General Provider Information

NPI Number	:	1538155908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY EDMOND NERVINO MD

Provider Business Mailing Address
First Line	:	2 UPPER RAGSDALE DR BLDG A
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-5736
Country	:	US
Telephone Number	:	831-333-3040
Fax Number	:	831-886-3639

Provider Business Practice Location Address
First Line	:	2 UPPER RAGSDALE DR BLDG A
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-5736
Country	:	US
Telephone Number	:	831-333-3040
Fax Number	:	831-886-3639

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	11/21/2019

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