Provider Demographics
NPI:1265669899
Name:CUNANAN, RUBILYN MEDALLA (NP)
Entity Type:Individual
Prefix:
First Name:RUBILYN
Middle Name:MEDALLA
Last Name:CUNANAN
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1011 BALDWIN PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-5806
Mailing Address - Country:US
Mailing Address - Phone:626-851-5476
Mailing Address - Fax:626-851-5475
Practice Address - Street 1:1011 BALDWIN PARK BLVD
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706
Practice Address - Country:US
Practice Address - Phone:626-851-5476
Practice Address - Fax:626-851-5475
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA18399363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner