Provider Demographics
NPI:1043498637
Name:MANGOSING IGNACIO, MARIA FLORINA ALETH D (NP)
Entity Type:Individual
Prefix:
First Name:MARIA FLORINA ALETH
Middle Name:D
Last Name:MANGOSING IGNACIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARIA FLORINA ALETH
Other - Middle Name:D
Other - Last Name:MANGOSING-IGNACIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1900 S PALM CANYON DR
Mailing Address - Street 2:PALM SPRINGS
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-8945
Mailing Address - Country:US
Mailing Address - Phone:760-320-5200
Mailing Address - Fax:
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:RANCHO MIRAGE
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-837-8535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16050363LA2200X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health