Individual
MONY PHEACHNAK SON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
18460 ROSCOE BLVD FL 3, NORTHRIDGE, CA 91325-4107
(818) 885-5480
(818) 993-1917
Mailing address
3400 DATA DR, ATTENTION: CREDENTIALING AND PAYER ENROLLMENT DEPT, RANCHO CORDOVA, CA 95670
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
A21867
CA
Other
Enumeration date
05/15/2022
Last updated
09/02/2025
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