Provider Demographics
NPI:1558128637
Name:MUNDIA, ESTHER GATHONI
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:GATHONI
Last Name:MUNDIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16818 SIERRA VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1848
Mailing Address - Country:US
Mailing Address - Phone:626-922-6997
Mailing Address - Fax:
Practice Address - Street 1:16818 SIERRA VISTA WAY
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1848
Practice Address - Country:US
Practice Address - Phone:626-922-6997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA732460163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse