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NPI Code Detail

MEDICARE: DR. DARYL HIDALGO NUCUM M.D.

MEDICARE: DR. DARYL HIDALGO NUCUM 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
12084P0800XPsychiatry PhysicianA054774CA
22084P0804XChild & Adolescent Psychiatry PhysicianA054774CA

General Provider Information

NPI Number : 1992832430
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DARYL HIDALGO NUCUM M.D.
Provider Business Mailing Address
First Line : 1301 PINE AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90813-3124
Country : US
Telephone Number : 562-595-1159
Fax Number : 562-981-7569
Provider Business Practice Location Address
First Line : 1301 PINE AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90813-3124
Country : US
Telephone Number : 562-595-1159
Fax Number : 562-981-7569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 02/10/2023

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