Provider Demographics
NPI:1972675999
Name:MUSTAFA, MONIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:
Last Name:MUSTAFA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 MAGNOLIA AVE
Mailing Address - Street 2:STE. A
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-3843
Mailing Address - Country:US
Mailing Address - Phone:951-682-9780
Mailing Address - Fax:951-682-9787
Practice Address - Street 1:7101 MAGNOLIA AVE
Practice Address - Street 2:STE.A
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504
Practice Address - Country:US
Practice Address - Phone:951-682-9780
Practice Address - Fax:951-682-9787
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA053844208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics