Individual
ANDREW PHETAROUN SOMPHONPHAKDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13229 EDWARDS RD, LA MIRADA, CA 90638-1823
(562) 587-0978
Mailing address
13229 EDWARDS RD, LA MIRADA, CA 90638-1823
(562) 587-0978
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
11/07/2021
Last updated
11/07/2021
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