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Individual

MARY ELAINE CONSTANTINO AGUILAR-CHOOMNGERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2801 ATLANTIC AVE, LONG BEACH, CA 90806-1701
(562) 933-3005
Mailing address
5601 WAGNER AVE, LAKEWOOD, CA 90712-1467

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
713511
CA
363LA2100X
Acute Care Nurse Practitioner
NP95009689
CA
363LA2200X
Adult Health Nurse Practitioner
NP95009689
CA
363LG0600X
Gerontology Nurse Practitioner
NP95009689
CA

Other

Enumeration date
08/12/2019
Last updated
08/12/2019
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