Provider Demographics
NPI:1225741978
Name:MONROE, LINDSAY (NP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:MONROE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 SAN BERNARDINO RD STE C
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4980
Mailing Address - Country:US
Mailing Address - Phone:909-981-8985
Mailing Address - Fax:
Practice Address - Street 1:1330 SAN BERNARDINO RD STE C
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4980
Practice Address - Country:US
Practice Address - Phone:909-981-8985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023682208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery