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1386123511
NICOLAS PHETNIRANH SENGDARA
MISSION VIEJO, CA
NPI
1386123511
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95009671)
Enumeration Date
2018-08-08
Last Update Date
2020-10-23
Business Address
NICOLAS PHETNIRANH SENGDARA NP-C
25272 MARGUERITE PKWY
MISSION VIEJO, CA 92692-2901
Phone number: 949-581-9120
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Mailing Address
NICOLAS PHETNIRANH SENGDARA NP-C
25272 MARGUERITE PKWY
MISSION VIEJO, CA 92692-2901
Phone number: 949-581-9120
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