Individual
CHARLES SANGMOAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2635 WALNUT ST, HUNTINGTON PARK, CA 90255
(323) 586-0740
Mailing address
2635 WALNUT ST, HUNTINGTON PARK, CA 90255
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
21348
CA
Other
Enumeration date
06/04/2011
Last updated
04/01/2016
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