Phonmany Phengphavong
NPI #1043849847 in Perris, California
Provider Information
- NPI Number
- 1043849847
- Entity Type
- Individual
- Name
- Phonmany Phengphavong
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Licensed Vocational Nurse
- Enumeration Date
- Apr 3, 2020
- Last Updated
- Apr 3, 2020
Practice Location
- Address
- 1688 N PERRIS BLVD
- City
- Perris
- State
- California
- ZIP Code
- 92571-4709
- Phone
- (951) 443-2200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Vocational Nurse |
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