Provider Demographics
NPI:1932673290
Name:MUNOZ, LAURA MICHAEL (LVN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MICHAEL
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6538 PURDY AVE
Mailing Address - Street 2:
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201-3016
Mailing Address - Country:US
Mailing Address - Phone:323-679-4032
Mailing Address - Fax:
Practice Address - Street 1:701 W CESAR E CHAVEZ AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2104
Practice Address - Country:US
Practice Address - Phone:213-217-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN691836164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse