Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A123629 | CA |
NPI | 1013286772 |
---|---|
Provider Name | Nicholas J Mondek |
First Address | Torrance, CA 90503-1006 |
Second Address | Torrance, CA 90503-4607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2011 |
Last Update Date | 25/04/2016 |