NICOLAS PHETNIRANH SENGDARA

MISSION VIEJO, CA
NPI1386123511
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: CA  95009671)
Enumeration Date2018-08-08
Last Update Date2020-10-23
Business Address
NICOLAS PHETNIRANH SENGDARA NP-C
25272 MARGUERITE PKWY
MISSION VIEJO, CA 92692-2901
Phone number: 949-581-9120
Mailing Address
NICOLAS PHETNIRANH SENGDARA NP-C
25272 MARGUERITE PKWY
MISSION VIEJO, CA 92692-2901
Phone number: 949-581-9120