Individual
DR. KRIS SIRIRATSIVAWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-7579
Mailing address
2609 W CANYON AVE, APT 303, SAN DIEGO, CA 92123-4729
(412) 606-5166
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14967
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/27/2007
Last updated
03/07/2018
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