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General NPI Number Information
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NPI Number | 1306845946
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Entity Type | Individual
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Provider Name | JUDITH A HARRISON-MONGE-REINER M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 01/10/2013
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Provider Practice Location Address
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Address Line | 16100 SAND CANYON AVE SUITE 130
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City | IRVINE
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State | CA
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Zip | 92867
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Country | US
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Telephone | 949-417-1100
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Fax | 949-417-1165
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Provider Business Mailing Address
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Address Line | PO BOX 10050
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City | MANHATTAN BEACH
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State | CA
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Zip | 90267-7550
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Country | US
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Telephone | 310-335-4956
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Fax | 310-335-4098
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | A23191
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License Number State | CA
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