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MARTHA BANUELOS — OIG Excluded Provider (BUENA PARK, CA, 1128b4)

MARTHA BANUELOS — OIG Excluded Provider (BUENA PARK, CA, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: MARTHA BANUELOS; Type: Individual; Provider category: NURSING PROFESSION.

NameMARTHA BANUELOS
TypeIndividual
Provider categoryNURSING PROFESSION
SpecialtyNURSE/NURSES AIDE
CityBUENA PARK
StateCA
ZIP90620
Exclusion authority1128b4
Exclusion reasonLicense revocation, suspension, or surrender
Exclusion date2004-12-20
SourceHHS-OIG LEIE

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