PONGMAKTHIKRAKSORIVO PATRICK SISOWATH

SANTA FE SPRINGS, CA
NPI1962218560
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
Enumeration Date2024-12-09
Last Update Date2024-12-09
Business Address
PONGMAKTHIKRAKSORIVO PATRICK SISOWATH
10425 PAINTER AVE
SANTA FE SPRINGS, CA 90670-3429
Phone number: 562-906-2685
Mailing Address
PONGMAKTHIKRAKSORIVO PATRICK SISOWATH
12070 TELEGRAPH RD
SANTA FE SPRINGS, CA 90670-3771
Phone number: 562-777-7500
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