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Organization
PACIFIC KIDNEY CARE CORP
Active
Organization
PACIFIC KIDNEY CARE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAURINO NUNEZ AVELAR MD (PHYSICIAN OWNER)
(702) 672-1141
Entity
Organization
Contact information
Practice address
243 GREEN VALLEY RD STE A, FREEDOM, CA 95019-3133
(702) 672-1141
Mailing address
243 GREEN VALLEY RD STE A, FREEDOM, CA 95019-3133
(702) 672-1141
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A126407
MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
11/09/2020
Last updated
11/09/2020
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