Doctor Name: | MIRNA TOVALIN |
NPI Number: | 1215398474 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | NP95003844 |
Business Practice Address: | 16404 Colima Rd Ste Fl1 Hacienda Heights, CA - 917455502 |
Business Phone Number: | 6265818330 |
Business Fax Number: | |
Mailing Address: | 16101 Glencove Dr, HACIENDA HEIGHTS |
State: | CA |
Postal Code: | 917456515 |
Phone Number: | 6263224204 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2016 |
NPI Last Update Date: | 03/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | NP95003844 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |