PRASEUTH SOUVANNAVONG

SANTA ANA, CA
NPI1982928412
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2010-03-26
Last Update Date2010-11-30
Business Address
-- PRASEUTH SOUVANNAVONG
2740 S BRISTOL ST 218
SANTA ANA, CA 92704-6209
Phone number: 714-754-8200
Mailing Address
-- PRASEUTH SOUVANNAVONG
2740 S BRISTOL ST 218
SANTA ANA, CA 92704-6209
Phone number: 714-754-8200