Basic Information
| Provider Information | |||||||||
| NPI: | 1144329574 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUN | ||||||||
| FirstName: | CARLOS | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 48 BERNARD ST | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024611904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6179695918 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 VFW PKWY | ||||||||
| Address2: | |||||||||
| City: | WEST ROXBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021324927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8572036835 | ||||||||
| FaxNumber: | 8572035680 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 60087 | MA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.