Individual
DIANA SIRIPORN PHEUGPHOONPHOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
580 S SAN VICENTE BLVD, LOS ANGELES, CA 90048-4621
(323) 782-1500
Mailing address
580 S SAN VICENTE BLVD, LOS ANGELES, CA 90048-4621
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
CA
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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