Individual
JI EUN VONGPHOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12341 ALAMO DR, RANCHO CUCAMONGA, CA 91739-2290
(323) 829-5485
Mailing address
12341 ALAMO DR, RANCHO CUCAMONGA, CA 91739-2290
(323) 829-5485
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP95010302
CA
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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