Provider Demographics
NPI:1679039093
Name:MUNOZ, MONICA KAMANTIGUE (MPH, MSHS, PA-C)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:KAMANTIGUE
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MPH, MSHS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 W 8TH ST STE 101-1
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-1002
Mailing Address - Country:US
Mailing Address - Phone:619-474-8666
Mailing Address - Fax:
Practice Address - Street 1:444 W 8TH ST STE 101-1
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-1002
Practice Address - Country:US
Practice Address - Phone:619-474-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56297363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant