MARK BOUNTHAVONG

SAN DIEGO, CA
NPI1720272578
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: CA  RPH55969)
Enumeration Date2007-09-04
Last Update Date2007-09-04
Business Address
DR. MARK BOUNTHAVONG PHARM.D.
3350 LA JOLLA VILLAGE DR # 119
SAN DIEGO, CA 92161-0002
Phone number: 858-552-8585
Mailing Address
DR. MARK BOUNTHAVONG PHARM.D.
3950 MAHAILA AVE APT M30
SAN DIEGO, CA 92122-5742
Phone number: 213-268-5425
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