Individual
MANILATH VONGSAVATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RCP, RT
Contact information
Practice address
4647 ZION AVE, SAN DIEGO, CA 92120-2507
(619) 528-5019
Mailing address
1145 CAMINO DEL REY, CHULA VISTA, CA 91910-7056
(619) 621-5311
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
25657
CA
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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