Individual
IGNACIO MARCOS CARRILLO-NUNEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1045 ATLANTIC AVE, STE 719, LONG BEACH, CA 90813-3412
(562) 591-1324
(562) 437-1054
Mailing address
18111 BROOKHURST ST, 6200, FOUNTAIN VALLEY, CA 92708-6728
(714) 378-5516
(714) 378-5517
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A51049
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A0510490
—
CA
01
—
CK323Z
MEDICARE PTAN
CA
Enumeration date
10/31/2005
Last updated
09/09/2016
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