Esther Bolanos, RN

Individual provider Active NPI Registered Nurse · Mentone, CA

NPI 1083187645 · NPPES record last updated Sep 4, 2021

Key facts

NPI
1083187645
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
807082 (CA)
Practice address
1370 Tourmaline Ave
Mentone, CA 92359-1239
Phone
(323) 534-0102
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
807082CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 807082 CA Yes

Addresses

Primary practice location

1370 Tourmaline Ave
Mentone, CA 92359-1239

Mailing address

1370 Tourmaline Ave
Mentone, CA 92359-1239
Phone (323) 534-0102

Other providers in Mentone, CA

All providers in Mentone, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.