Provider Demographics
NPI:1063936706
Name:MONROE, CARA
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:MONROE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 S OLIVE ST APT 309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3490
Mailing Address - Country:US
Mailing Address - Phone:205-253-4216
Mailing Address - Fax:
Practice Address - Street 1:MARTIN LUTHER KING JR. COMMUNITY HOSPITAL
Practice Address - Street 2:1680 E 120TH STREET
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059
Practice Address - Country:US
Practice Address - Phone:205-253-4216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA175211207ZH0000X, 207ZP0101X, 207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Multi-Specialty