Individual
MR. JEROME BOONSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
7500 HELLMAN AVE, ROSEMEAD, CA 91770-2216
(626) 288-1160
(626) 371-1329
Mailing address
2430 S MARCELLA AVE, WEST COVINA, CA 91792-2227
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
688333
CA
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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