Healthcare Provider Details

I. General information

NPI: 1851171383
Provider Name (Legal Business Name): MONIKA GURUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 EASTMOOR AVE
DALY CITY CA
94015-2036
US

IV. Provider business mailing address

211 EASTMOOR AVE
DALY CITY CA
94015-2036
US

V. Phone/Fax

Practice location:
  • Phone: 888-500-1886
  • Fax:
Mailing address:
  • Phone: 888-500-1886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113087
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: