Individual
MRS. CONSUELO GOMONIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
8215 VAN NUYS BLVD STE 210, PANORAMA CITY, CA 91402-4833
(818) 901-0373
Mailing address
3033 E VALLEY BLVD SPC 77, WEST COVINA, CA 91792-3320
(626) 523-2647
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95002270
CA
363LF0000X
Family Nurse Practitioner
95002270
CA
Other
Enumeration date
09/03/2015
Last updated
09/03/2015
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