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1144937327
VIVIAN MBONIFOR
GARDENA, CA
NPI
1144937327
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA 2022010372)
Enumeration Date
2022-10-28
Last Update Date
2023-04-17
Business Address
VIVIAN MBONIFOR
1225 W 190TH ST STE 280
GARDENA, CA 90248-4305
Phone number: 310-515-8113
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Mailing Address
VIVIAN MBONIFOR
1225 W 190TH ST STE 280
GARDENA, CA 90248-4305
Phone number:
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