Individual
MR. KONGPENG C MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
425 N CALIFORNIA ST STE 7, STOCKTON, CA 95202-2130
(209) 870-5000
(209) 870-5020
Mailing address
7820 CENTER PKWY APT 239, SACRAMENTO, CA 95823-4785
(209) 777-7446
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
8080705
CA
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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