Individual
CHANNE BUNTHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
390 N PACIFIC COAST HWY, EL SEGUNDO, CA 90245-4475
(562) 606-9165
Mailing address
500 AVENUE G APT 3, REDONDO BEACH, CA 90277-6006
(562) 606-9165
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95012449
CA
Other
Enumeration date
10/09/2019
Last updated
11/30/2021
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