Individual
MR. PHOLPHAT INPIROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3549 CASTLE GLEN DR UNIT 128, SAN DIEGO, CA 92123-2432
(619) 955-2360
Mailing address
3549 CASTLE GLEN DR UNIT 128, SAN DIEGO, CA 92123-2432
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
504629
CA
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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