Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 19099 | CA |
NPI | 1003140013 |
---|---|
Provider Name | Jomarie Esteban Monzon-Duller |
First Address | Chino Hills, CA 91709-1790 |
Second Address | Los Angeles, CA 90048 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2009 |
Last Update Date | 23/09/2009 |