KHWANTHIDA SOONTHORNPONG

SAN DIEGO, CA
NPI1053054361
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: CA  95032334)
Additional Taxonomies163W00000X Registered Nurse
(Licence: CA  95235554)
Enumeration Date2022-04-14
Last Update Date2025-04-10
Business Address
KHWANTHIDA SOONTHORNPONG NP
9388 LIGHTWAVE AVE
SAN DIEGO, CA 92123-1426
Phone number: 858-541-7710
Mailing Address
KHWANTHIDA SOONTHORNPONG NP
405 W 5TH ST
SANTA ANA, CA 92701-4599
Phone number: 714-647-6092