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1609457753
KANDAVIN THONG
BANNING, CA
NPI
1609457753
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95022634)
Enumeration Date
2021-04-20
Last Update Date
2023-02-27
Business Address
KANDAVIN THONG
6109 W RAMSEY ST
BANNING, CA 92220-3051
Phone number: 951-845-0313
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Mailing Address
KANDAVIN THONG
PO BOX 10069
SAN BERNARDINO, CA 92423-0069
Phone number: 909-335-4188
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