Individual
SOPHEAKTRA CHHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1415 GOULD ST APT B, SAN BERNARDINO, CA 92408-3082
(909) 534-8984
Mailing address
1415 GOULD ST APT B, SAN BERNARDINO, CA 92408-3082
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
95136161
CA
Other
Enumeration date
03/20/2021
Last updated
03/20/2021
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