Individual
YANISA CHUENKASAMEKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 W SAN BERNARDINO RD STE A, COVINA, CA 91722-3797
(626) 966-1909
(626) 209-0331
Mailing address
500 W SAN BERNARDINO RD STE A, COVINA, CA 91722-3797
(626) 966-1909
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
PA57288
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
542109211
TAX ID
CA
Enumeration date
10/16/2019
Last updated
06/23/2020
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