Provider Demographics
NPI:1023417284
Name:GOMEZ, MONICA KYUNG-MI (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:KYUNG-MI
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:K
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6900 PECOS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-4400
Mailing Address - Country:US
Mailing Address - Phone:702-791-9000
Mailing Address - Fax:
Practice Address - Street 1:8532 BATTERY CREST LN
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4123
Practice Address - Country:US
Practice Address - Phone:725-248-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV32310DI-0133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal