Provider Demographics
NPI:1336701440
Name:MONILLAS, LEO (MSN-FNP)
Entity Type:Individual
Prefix:
First Name:LEO
Middle Name:
Last Name:MONILLAS
Suffix:
Gender:M
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9344 CEDAR ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6442
Mailing Address - Country:US
Mailing Address - Phone:310-480-5698
Mailing Address - Fax:
Practice Address - Street 1:9344 CEDAR ST APT 5
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6442
Practice Address - Country:US
Practice Address - Phone:310-480-5698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011937363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily