Individual
CHUTIMA NINGSOMBOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
10316 WOODLEY AVE, GRANADA HILLS, CA 91344-6916
(818) 368-5651
(818) 363-4770
Mailing address
10316 WOODLEY AVE, GRANADA HILLS, CA 91344-6916
(818) 368-5651
(818) 363-4770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17271
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17271
PAC LICENSE
CA
Enumeration date
07/03/2006
Last updated
12/03/2007
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