Individual
KANOKWAN KULTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15850 BABCOCK ST, SAN DIEGO, CA 92127-3680
(858) 344-8536
Mailing address
15850 BABCOCK ST, SAN DIEGO, CA 92127-3680
(858) 344-8536
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95015361
CA
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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