Provider Demographics
NPI:1659661395
Name:H.E.A.L. MEDICAL CORP
Entity Type:Organization
Organization Name:H.E.A.L. MEDICAL CORP
Other - Org Name:MARSHA KAY NUNLEY MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:NUNLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-440-2200
Mailing Address - Street 1:2000 VAN NESS AVE
Mailing Address - Street 2:SUITE 501A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3023
Mailing Address - Country:US
Mailing Address - Phone:415-440-2200
Mailing Address - Fax:
Practice Address - Street 1:2000 VAN NESS AVE
Practice Address - Street 2:SUITE 501A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3023
Practice Address - Country:US
Practice Address - Phone:415-440-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50005261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF31716Medicare UPIN