Individual
ALINA PHOUTTHAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4309 THIRD AVENUE, SAN DIEGO, CA 92103
(619) 876-4502
Mailing address
39299 CARDIFF AVE, MURRIETA, CA 92563-3801
(951) 795-8206
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95384183
CA
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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