# SOMBATH SENETHONG, M.D.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972794089
- **Authorized official:** DR. SOMBATH SENETHONG M.D. (DIRECTOR)
- **Authorized official phone:** (619) 262-8626

## Contact information

- **Practice address:** 1748 EUCLID AVE, SAN DIEGO, CA 92105-5415
- **Practice address phone:** (619) 262-8626
- **Practice address fax:** (619) 262-8620
- **Mailing address:** 1748 EUCLID AVE, SAN DIEGO, CA 92105-5415
- **Mailing address phone:** (619) 262-8626
- **Mailing address fax:** (619) 262-8620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 208D00000X | CA | Yes |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 08/05/2007