Individual
MISS SONEMALA PHOMMATHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1721 E 19TH AVE STE 500, DENVER, CO 80218-1242
(303) 762-3472
Mailing address
1721 E 19TH AVE STE 500, DENVER, CO 80218-1242
(303) 762-3472
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0002374
CO
363AS0400X
Surgical Physician Assistant
Primary
PA.0002374
CO
Other
Enumeration date
03/30/2007
Last updated
08/20/2025
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