Individual
SUMANA SOONTHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7841 BALBOA AVE STE 204, SAN DIEGO, CA 92111-2313
(619) 876-8033
Mailing address
4690 MISSION BLVD, SAN DIEGO, CA 92109-2734
(619) 634-6349
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
81586
CA
Other
Enumeration date
10/11/2023
Last updated
08/14/2024
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