Provider Demographics
NPI:1811441322
Name:BUENO, DAISY (RN, BSN)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:BUENO
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:DAISY
Other - Middle Name:
Other - Last Name:MORSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1050 GEORGIA ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-3034
Mailing Address - Country:US
Mailing Address - Phone:619-878-0270
Mailing Address - Fax:
Practice Address - Street 1:1050 GEORGIA ST
Practice Address - Street 2:UNIT B
Practice Address - City:IMPERIAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:91932-3034
Practice Address - Country:US
Practice Address - Phone:619-878-0270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA680769163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse