Individual
MRS. MAYDOLE LOPEZ ALDALUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
12100 EUCLID ST, GARDEN GROVE, CA 92840-3304
(833) 574-2273
Mailing address
7931 WESTRA LN, LA PALMA, CA 90623-1844
(562) 810-4534
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95000492
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
755895
BOARD OF REGISTERED NURSING
CA
01
—
95000492
BOARD OF REGISTERED NURSING
CA
Enumeration date
04/26/2014
Last updated
01/18/2023
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