Provider Demographics
NPI:1548925985
Name:HUNTER, LA RONDA (MASTECTOMY FITTER)
Entity type:Individual
Prefix:
First Name:LA RONDA
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MASTECTOMY FITTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16815 PRAIRIE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-3009
Mailing Address - Country:US
Mailing Address - Phone:310-370-7757
Mailing Address - Fax:
Practice Address - Street 1:16815 PRAIRIE AVE STE B
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-3009
Practice Address - Country:US
Practice Address - Phone:310-370-7757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy Fitter
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty