Provider Demographics
NPI:1417378159
Name:BANG, MONICA (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:BANG
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 W HUNTINGTON DR
Mailing Address - Street 2:STE. 215
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-3462
Mailing Address - Country:US
Mailing Address - Phone:626-446-4663
Mailing Address - Fax:
Practice Address - Street 1:301 W HUNTINGTON DR
Practice Address - Street 2:STE. 215
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3462
Practice Address - Country:US
Practice Address - Phone:626-446-4663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-24
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21392363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health