Individual
FAM FOW SAEFONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
990 EDDY ST, SAN FRANCISCO, CA 94109-7713
(510) 965-5995
Mailing address
2865 OXFORD AVE, RICHMOND, CA 94806-2616
(510) 965-5995
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
09/25/2018
Last updated
03/04/2019
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