Provider Demographics
NPI:1427803444
Name:INZUNZA, MIRIAM (FNP-C)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:INZUNZA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10508 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-1452
Mailing Address - Country:US
Mailing Address - Phone:562-396-7076
Mailing Address - Fax:
Practice Address - Street 1:10508 NASHVILLE AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-1452
Practice Address - Country:US
Practice Address - Phone:562-396-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029873207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine