Basic Information
Provider Information
NPI: 1003140013
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MONZON-DULLER
FirstName: JOMARIE
MiddleName: ESTEBAN
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14017 RAVENWOOD DR
Address2:  
City: CHINO HILLS
State: CA
PostalCode: 917091790
CountryCode: US
TelephoneNumber: 3235809289
FaxNumber:  
Practice Location
Address1: 8730 ALDEN DRIVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 90048
CountryCode: US
TelephoneNumber: 3104230926
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/23/2009
LastUpdateDate: 09/23/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC0200X698890CAN Nursing Service ProvidersRegistered NurseCritical Care Medicine
363LF0000X19099CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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