MS. LILLIAN GRAY MGONJA REGISTERED NURSE
Nursing Yellow Pages
Compton, California
Provider NPI: 1851624571
Provider Information:MS. LILLIAN GRAY MGONJA REGISTERED NURSE
Practice Location:
623 S. LONG BEACH BLVD SUITE A/B COMPTON, CA 90221 US
Tel: 310-637-0341 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 163WA0400X | Nursing Service Providers Registered Nurse Addiction (Substance Use Disorder) | CA | 581333 |
Y | 163WA2000X | Nursing Service Providers Registered Nurse | CA | 581433 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
REGISTERD NURSE | 581433 | CA | 01 |
RN LICENSE | 581433 | CA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin