Individual
GEENA DAGALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
CLINIC OF MANUEL F MENDOZA, MD, 11735 FIRESTONE BLVD, NORWALK, CA 90650
(562) 925-7716
Mailing address
7659 GRANADA DR, BUENA PARK, CA 90621-1212
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
749726
CA
363LF0000X
Family Nurse Practitioner
95007818
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95007818
CA
Other
Enumeration date
10/24/2017
Last updated
07/09/2022
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