MEDICARE: HERIBERTO NUNEZ MD, A PROFESSIONAL CORPORATION

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	207Q00000X	Family Medicine Physician

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
2	1891947768	OTHER	CA	HMO

General Provider Information

NPI Number	:	1891947768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERIBERTO NUNEZ MD, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	850 S ATLANTIC BLVD STE 203
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-6707
Country	:	US
Telephone Number	:	626-284-3111
Fax Number	:	626-872-2450

Provider Business Practice Location Address
First Line	:	850 S ATLANTIC BLVD STE 203
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-6707
Country	:	US
Telephone Number	:	626-284-3111
Fax Number	:	626-872-2450

Authorized Official
Title or Position	:	DOCTOR
Name	:	HERIBERTO NUNEZ
Credential	:	M.D.
Telephone Number	:	626-284-3111

Provider Enumeration Date	:	10/22/2008
Last Update Date	:	08/31/2020

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