MEDICARE: JELENA KUNOVAC 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	2084P0800X	Psychiatry Physician	13703	NV
2	2084P0800X	Psychiatry Physician	50512	AZ
3	2084P0800X	Psychiatry Physician	A66135	CA

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	:	1851402259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JELENA KUNOVAC M.D.

Provider Business Mailing Address
First Line	:	3998 VISTA WAY
Second Line	:	SUITE 100
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-4514
Country	:	US
Telephone Number	:	760-806-1800
Fax Number	:	760-806-1801

Provider Business Practice Location Address
First Line	:	3012 W CHARLESTON BLVD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1972
Country	:	US
Telephone Number	:	702-527-7401
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	04/15/2022

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