Jimenez, Imelda Medina

Jimenez, Imelda Medina is an individual health care provider with primary practice located at 1433 W Merced Ave 103, West Covina CA 91790-3402. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jimenez, Imelda Medina can be contacted via phone (626) 337-8000.

Contact Information

Primary practice address
1433 W Merced Ave 103 West Covina CA 91790-3402
Fax: (626) 337-1145
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 416351 California

Profile Details

NPI number 1477753721
LBN Legal business name Jimenez, Imelda Medina
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2007
Last updated Nov 8th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477753721 NPPES
California Other 416351 NP LICENSE

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