Individual
ELTON M PHOPROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1520 MONTEBELLO DR, SUISUN CITY, CA 94585-3008
(707) 863-2656
Mailing address
1520 MONTEBELLO DR, SUISUN CITY, CA 94585-3008
(707) 863-2656
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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