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1245875327
KONGPENG C MOUA
STOCKTON, CA
NPI
1245875327
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: CA 8080705)
Enumeration Date
2019-11-12
Last Update Date
2019-11-12
Business Address
Mr. KONGPENG C MOUA RD
425 N CALIFORNIA ST STE 7
STOCKTON, CA 95202-2130
Phone number: 209-870-5000
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Mailing Address
Mr. KONGPENG C MOUA RD
7820 CENTER PKWY APT 239
SACRAMENTO, CA 95823-4785
Phone number: 209-777-7446
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