| Ignacio M Carrillo Nunez Md Pc | |
|
18111 Brookhurst St Suite 6200 Fountain Valley CA 92708-6728 | |
| (714) 797-9027 | |
| (714) 378-5517 |
| Full Name | Ignacio M Carrillo Nunez Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 18111 Brookhurst St, Fountain Valley, California |
| Authorized Official Name and Position | Ignacio Marcos Carrillo-nunez (PRESIDENT) |
| Authorized Official Contact | 7147979027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ignacio M Carrillo Nunez Md Pc 18111 Brookhurst St Suite 6200 Fountain Valley CA 92708-6728 Ph: (714) 797-9027 | Ignacio M Carrillo Nunez Md Pc 18111 Brookhurst St Suite 6200 Fountain Valley CA 92708-6728 Ph: (714) 797-9027 |
| NPI Number | 1659720811 |
|---|---|
| Provider Enumeration Date | 06/08/2016 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Medicare PECOS PAC ID | 9739476128 |
|---|---|
| Medicare Enrollment ID | O20160928002983 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659720811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084V0102X | Psychiatry & Neurology - Vascular Neurology | A051049 (California) | Primary |
| Provider Name | Ignacio M Carrillo-nunez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205827201 PECOS PAC ID: 8921146937 Enrollment ID: I20091112000122 |
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