Organization
BEST WOUND AND DIABETES CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHAMPHA THEPHAVONG D.O. (PRESIDENT/CEO)
(559) 226-1284
Entity
Organization
Contact information
Practice address
2205 N FRESNO ST, C, FRESNO, CA 93703-2210
(559) 226-1284
(559) 226-1211
Mailing address
2205 N FRESNO ST, C, FRESNO, CA 93703-2210
(559) 226-1284
(559) 226-1211
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
209790
CA
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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