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Individual

MEDIA R MUPANDUKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1501 HUGHES WAY STE 150, LONG BEACH, CA 90810-1878
(310) 221-6336
Mailing address
1501 HUGHES WAY STE 150, LONG BEACH, CA 90810-1878
(310) 221-6336

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95016352
CA
363LP2300X
Primary Care Nurse Practitioner
95016352
CA
363LP2300X
Primary Care Nurse Practitioner
AP139444
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP139444
FAMILY NURSE PRACTITIONER
TX
Enumeration date
10/24/2018
Last updated
04/01/2022
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