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NPI Code Detail

MEDICARE: BOBBIE MONGER

MEDICARE: BOBBIE MONGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1033766696
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBIE MONGER
Provider Business Mailing Address
First Line : 5731 W SLAUSON AVE STE 210
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6982
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1564 W 36TH PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-4503
Country : US
Telephone Number : 323-766-9415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2019
Last Update Date : 08/19/2019

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Directions to “ BOBBIE MONGER ” Practice Location

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