NPI Profile for MAYRA S PONCE in HUNTINGTON PARK, CA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Registered Nurse |
163W00000X | |||
Surgical Assistant |
246ZC0007X |
| NPI # | 1225549439 |
|
| Status | Active | |
| Credentials | FNP (Family Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 10/14/2017 | |
| Last updated | 09/06/2024 - More than a year ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MAYRA S PONCE
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