Provider Demographics
NPI:1730385352
Name:KUENZIG, EMANUEL ROBERT JR (RN)
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:ROBERT
Last Name:KUENZIG
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 WILDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3806
Mailing Address - Country:US
Mailing Address - Phone:909-427-3772
Mailing Address - Fax:909-427-3750
Practice Address - Street 1:9310 SIERRA AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-5711
Practice Address - Country:US
Practice Address - Phone:909-427-3772
Practice Address - Fax:909-427-3750
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA333720163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health