Individual
MARVIN LOUIE SUNPONGCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
5888 EDINGER AVE, HUNTINGTON BEACH, CA 92649-1705
(714) 716-2900
(714) 716-2909
Mailing address
5888 EDINGER AVE, HUNTINGTON BEACH, CA 92649-1705
(714) 716-2900
(714) 716-2909
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95024557
CA
Other
Enumeration date
04/10/2023
Last updated
08/02/2023
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