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Individual
MRS. NEVA MARIE MONIGATTI LAKE
Active
Individual
MRS. NEVA MARIE MONIGATTI LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G58310
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G583100
—
CA
01
—
080061188
RAILROAD MEDICARE
CA
01
—
ZZZ627762
BLUE SHIELD
CA
Enumeration date
05/24/2006
Last updated
10/18/2013
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