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Individual

BENJA VONGTONGDEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
1240 TRUMAN ST, SAN FERNANDO, CA 91340-3203
(818) 403-6559
(818) 403-6568
Mailing address
25115 AVENUE STANFORD STE B135, VALENCIA, CA 91355-1290
(661) 250-9940
(661) 250-9959

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49857
CA

Other

Enumeration date
08/17/2021
Last updated
08/17/2021
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