Individual
THIDA TEP KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
795 FOLSOM ST FL 1, SAN FRANCISCO, CA 94107-4226
(855) 832-6727
Mailing address
2532 ROBIN CT, UNION CITY, CA 94587-3152
(415) 407-9974
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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