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General NPI Number Information
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NPI Number | 1154949451
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Entity Type | Individual
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Provider Name | ORADEE BONNY AUEYONG FNP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 4065 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90023-2556
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Country | US
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Telephone | 323-968-1170
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Fax | 323-968-1175
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Provider Business Mailing Address
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Address Line | 15906 ATOKA RD
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City | APPLE VALLEY
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State | CA
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Zip | 92307-2749
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Country | US
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Telephone | 626-226-8706
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95014776
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License Number State | CA
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