Individual
MRS. SUWAPANG PATTUMMADITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1818 N ORANGE GROVE, STE 104, POMONA, CA 91767-3028
(909) 592-2816
Mailing address
1818 N ORANGE GROVE, STE 104, POMONA, CA 91767-3028
(909) 592-2816
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A32823
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A328231
—
CA
01
—
WA32823A
MEDICARE PTAN
CA
Enumeration date
06/06/2006
Last updated
11/10/2008
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