Individual
STEPHANIE E PONGRACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2020 SANTA MONICA BLVD, SUITE 400, SANTA MONICA, CA 90404-2023
(310) 928-2663
(310) 315-2198
Mailing address
1658 CAMDEN AVE, NO 105, LOS ANGELES, CA 90025-7548
(805) 403-3755
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA20968
CA
Other
Enumeration date
08/20/2010
Last updated
12/09/2014
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