Provider Demographics
NPI:1013503283
Name:MULI, DOROTHY MBULA
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:MBULA
Last Name:MULI
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 1:22827 MOUNTAIN ASH CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-5006
Mailing Address - Country:US
Mailing Address - Phone:949-878-6995
Mailing Address - Fax:
Practice Address - Street 1:22827 MOUNTAIN ASH CIR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-5006
Practice Address - Country:US
Practice Address - Phone:949-878-6995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA761193163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse