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1265188221
THIRAT CHAKAVANMONGKOL
NORTH HOLLYWOOD, CA
NPI
1265188221
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95020085)
Enumeration Date
2022-02-28
Last Update Date
2022-02-28
Business Address
THIRAT CHAKAVANMONGKOL
12215 VICTORY BLVD
NORTH HOLLYWOOD, CA 91606-3206
Phone number: 818-299-5500
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Mailing Address
THIRAT CHAKAVANMONGKOL
7418 VANTAGE AVE
NORTH HOLLYWOOD, CA 91605-3609
Phone number: 818-653-0176
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