MEDICARE: LUVIMIN RUNAS

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	163W00000X	Registered Nurse	RN95235743	CA

General Provider Information

NPI Number	:	1861088072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUVIMIN RUNAS

Provider Business Mailing Address
First Line	:	235 E 67TH WAY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-1205
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 E 67TH WAY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-1205
Country	:	US
Telephone Number	:	562-702-8397
Fax Number	:

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

Provider Enumeration Date	:	12/12/2020
Last Update Date	:	12/12/2020

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Directions to “ LUVIMIN RUNAS ” Practice Location

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