MIKEY THANTERAPHONG

Nurse Practitioner

NPI: 1437795333IndividualAccepts Medicare

Specialties, Licenses & Credentials

Nurse PractitionerPrimary

Nurse Practitioner

Code: 363L00000X

95013063(CA)

Education

OTHER

Class of 2016

Contact & Hours

Address: 2845 COCHRAN ST STE B
SIMI VALLEY, CA 93065
Phone: (818) 835-7355

Location

Practice Location

2845 COCHRAN ST STE B, SIMI VALLEY, CA

Quick Facts

NPI: 1437795333
Entity Type: Individual
Gender: Male
Medicare: Accepted
Specialties: 1
Locations: 1
Years in Practice: 10

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