Provider Demographics
NPI:1245237445
Name:JENNINGS-NUNEZ, CHASITY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHASITY
Middle Name:
Last Name:JENNINGS-NUNEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 CESAR CHAVEZ
Mailing Address - Street 2:#225/200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033
Mailing Address - Country:US
Mailing Address - Phone:323-225-4300
Mailing Address - Fax:323-225-1803
Practice Address - Street 1:1701 CESAR CHAVEZ
Practice Address - Street 2:#225/200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-225-4300
Practice Address - Fax:323-225-1803
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61723207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A617230Medicaid
CA00A617230Medicaid
G96722Medicare UPIN