Individual
MICHELLE SRIWONGTONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
834 CASTRO ST, 3, SAN FRANCISCO, CA 94114-2858
(415) 940-0264
Mailing address
245 S FETTERLY AVE, LOS ANGELES, CA 90022-1605
(323) 362-1010
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
145266
CA
Other
Enumeration date
04/10/2015
Last updated
05/19/2020
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