Organization
THAWAT EOSAKUL,M.D.INC.
Active
Organization
THAWAT EOSAKUL,M.D.INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAWAT EOSAKUL M.D. (PRESIDENT)
(909) 350-3091
Entity
Organization
Contact information
Practice address
16860 SEVILLE AVE, FONTANA, CA 92335-3561
(909) 350-3091
(909) 350-1172
Mailing address
16860 SEVILLE AVE, FONTANA, CA 92335-3561
(909) 350-3091
(909) 350-1172
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A32349
CA
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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