Individual provider · Type 1 NPI
Lillian Gray Mgonja, REGISTERED NURSE
Administrator Registered Nurse · Compton, CA
NPI number
1851624571
Active
Practice location
623 S. Long Beach Blvd, Suite A/b
Compton, CA 90221
Fax (310) 637-0341
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | 581333 (CA) |
| Administrator Registered Nurse Primary | 163WA2000X | 581433 (CA) |
Administrator Registered Nurse: Definition to come...
About NPI 1851624571
Lillian Gray Mgonja, REGISTERED NURSE's National Provider Identifier is 1851624571, issued on Sep 14, 2009. The primary taxonomy on file is Administrator Registered Nurse (163WA2000X), and the practice location is in Compton, CA. The record was last updated on Sep 14, 2009.