Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | CA5633 | CA |
NPI | 1215520291 |
---|---|
Provider Name | Ms. Monique Chevette Lumpkin |
First Address | San Bernardino, CA 92410-2133 |
Second Address | Riverside, CA 92501-1779 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2021 |
Last Update Date | 19/02/2021 |