Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A12654 | CA |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 262860 | NY |
NPI | 1235392382 |
---|---|
Provider Name | Victor Alexander Nuno |
First Address | Santa Cruz, CA 95060-4136 |
Second Address | Vallejo, CA 94590-4638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 30/07/2021 |