Doctor Name: | ANGELITA DOMINGO BUENO |
NPI Number: | 1023077492 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | NP12567 |
Business Practice Address: | 1403 Lomita Blvd Harbor City, CA - 907102076 |
Business Phone Number: | 3107845800 |
Business Fax Number: | 3105309811 |
Mailing Address: | 325 Palm Ct, CARSON |
State: | CA |
Postal Code: | 907453100 |
Phone Number: | 3108352301 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2006 |
NPI Last Update Date: | 12/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | NP12567 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |