Individual
MR. AIRNOI N/A PHONGSAVATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
3103 E CARTWRIGHT AVE, FRESNO, CA 93725-9385
(559) 498-7100
Mailing address
3133 N MILLBROOK AVE, FRESNO, CA 93703-1425
(559) 394-9628
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
293096
CA
Other
Enumeration date
04/18/2018
Last updated
03/13/2024
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