Provider Demographics
NPI:1760047930
Name:DEL MUNDO, NINA CHRISTINE
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:CHRISTINE
Last Name:DEL MUNDO
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 1:2901 W COAST HWY STE 150
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4030
Mailing Address - Country:US
Mailing Address - Phone:949-650-7267
Mailing Address - Fax:
Practice Address - Street 1:5817 E WEST VIEW DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-4315
Practice Address - Country:US
Practice Address - Phone:714-322-8339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program