PATANA PONGVARIN

COSTA MESA, CA
NPI1649762188
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: CA  VN227571)
Enumeration Date2018-05-31
Last Update Date2018-05-31
Business Address
PATANA PONGVARIN
275 VICTORIA ST STE 1H
COSTA MESA, CA 92627-1906
Phone number: 949-629-2862
Mailing Address
PATANA PONGVARIN
275 VICTORIA ST STE 1H
COSTA MESA, CA 92627-1906
Phone number: 949-629-2862
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