Individual
GRACE M LOMIBAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGACNP-BC
Contact information
Practice address
13517 BROWNING PL, LA PUENTE, CA 91746-1968
(951) 258-8758
Mailing address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95012594
CA
Other
Enumeration date
09/16/2019
Last updated
03/11/2020
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