Organization
DR. SI POKPONGKIAT OPTOMETRY,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SI POKPONGKIAT O.D. (PRESIDENT)
(323) 663-8346
Entity
Organization
Contact information
Practice address
1609 N VERMONT AVE, LOS ANGELES, CA 90027-5312
(323) 663-8346
Mailing address
1609 N VERMONT AVE, LOS ANGELES, CA 90027-5312
(323) 663-8346
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9071T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558443192
INDIVIDUAL NPI
CA
05
—
SD0090710
—
CA
Enumeration date
04/17/2007
Last updated
10/18/2012
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