Individual
MARK BOONYASAMPANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E VALENCIA MESA DR, FULLERTON, CA 92835-3809
(510) 388-7271
(714) 446-7546
Mailing address
101 E VALENCIA MESA DR, FULLERTON, CA 92835-3809
(510) 388-7271
(714) 446-7546
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A126158
CA
Other
Enumeration date
05/06/2011
Last updated
07/21/2022
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