Provider Demographics
NPI:1417146150
Name:NUNEZ, DAVID GUERRERO III (LVN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:GUERRERO
Last Name:NUNEZ
Suffix:III
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 LORETTA ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-2253
Mailing Address - Country:US
Mailing Address - Phone:760-586-4311
Mailing Address - Fax:
Practice Address - Street 1:1630 LORETTA ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-2253
Practice Address - Country:US
Practice Address - Phone:760-586-4311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 165141164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARVN000510OtherPROVIDER NUMBER