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1407552060
CHAIYAPORN CHARLES VATANATHAM
LOS ANGELES, CA
NPI
1407552060
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-02-06
Last Update Date
2023-03-23
Business Address
CHAIYAPORN CHARLES VATANATHAM
757 WESTWOOD PLAZA, INTERNAL MEDICINE
LOS ANGELES, CA 90095-7419
Phone number: 310-825-7375
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Mailing Address
CHAIYAPORN CHARLES VATANATHAM
885 TIVERTON DRIVE
LOS ANGELES, CA 90095-0001
Phone number: 310-825-6373
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