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Organization
SUTTIRAK CHAIWONGKARJOHN, INC.
Active
Organization
SUTTIRAK CHAIWONGKARJOHN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUTTIRAK CHAIWONGKARJOHN M.D (CEO)
(818) 477-4700
Entity
Organization
Contact information
Practice address
24123 DEL MONTE DR UNIT 95, VALENCIA, CA 91355-3819
(818) 477-4700
Mailing address
24123 DEL MONTE DR UNIT 95, VALENCIA, CA 91355-3819
(818) 477-4700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A115809
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A115809
LICENSE
CA
Enumeration date
04/18/2017
Last updated
04/20/2017
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