# SERGIO A. FUENZALIDA MD INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730493198
- **Authorized official:** SERGIO A FUENZALIDA M.D. (OWNER)
- **Authorized official phone:** (626) 576-7481

## Contact information

- **Practice address:** 850 S ATLANTIC BLVD, SUITE 103, MONTEREY PARK, CA 91754-6703
- **Practice address phone:** (626) 576-7481
- **Mailing address:** 850 S ATLANTIC BLVD, SUITE 103, MONTEREY PARK, CA 91754-4730
- **Mailing address phone:** (626) 576-7481

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | A25157 | CA | Yes |

## Other

- **Enumeration date:** 07/27/2010
- **Last updated:** 08/03/2010