Individual
JOHNNY KIMLEANG SOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21017 VIOLETA AVE, LAKEWOOD, CA 90715-2139
(562) 330-7120
Mailing address
21017 VIOLETA AVE, LAKEWOOD, CA 90715-2139
(562) 330-7120
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21865
CA
Other
Enumeration date
01/01/2021
Last updated
01/01/2021
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