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Individual

PHONGSATHORN THANYAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
150 ROCKVIEW, IRVINE, CA 92612-3224
(949) 572-3599
Mailing address
150 ROCKVIEW, IRVINE, CA 92612-3224
(949) 572-3599

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
97281
CA

Other

Enumeration date
09/16/2024
Last updated
09/16/2024
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