Individual
MITZI HAZELLE BAGUIORO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
6652 COYOTE TRAIL LN, EASTVALE, CA 92880-3723
(818) 613-3551
Mailing address
6652 COYOTE TRAIL LN, EASTVALE, CA 92880-3723
(818) 613-3551
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP95008987
CA
Other
Enumeration date
12/01/2018
Last updated
12/01/2018
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