Victoria Mangunsong

NPI 1184717795 - Clinic/Center - 261QP2000X

NPI Details
NPI 1184717795
Enumeration Date 10/02/2006
Last Updated 08/06/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name VICTORIA P VICTORIA
Position OWNER
Phone (909) 796-9400
Fax
Practice Location
11354 MOUNTAIN VIEW AVE
SUITE C
LOMA LINDA CA, 92354-3855, US
Phone (909) 796-9400
Fax
Business Location
11354 MOUNTAIN VIEW AVE
SUITE C
LOMA LINDA CA, 92354-3855, US
Phone (909) 796-9400
Fax
Toxanomy
Taxonomy Code 261QP2000X
License State California
License Number PT26565
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According to our database, Victoria Mangunsong NPI is 1184717795, taxonomy code is 261QP2000X and license number is PT26565, license state is located at California. Victoria Mangunsong physically located at 11354 Mountain View Ave, Loma Linda CA, 92354-3855. NPI Number 1033115704 has the healthcare provider type.

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1184717795 NPI number is provided on an as is basis without warranty of any kind. 1184717795 is maintained by the National Plan & Provider Enumeration System. The contents of Victoria Mangunsong are for informational purposes only.