| Sornya Ponrartana Md Inc | |
|
3526 W 1st St Santa Ana CA 92703-3302 | |
| (714) 839-6611 | |
| (714) 839-6612 |
| Full Name | Sornya Ponrartana Md Inc |
|---|---|
| Speciality | General Practice |
| Location | 3526 W 1st St, Santa Ana, California |
| Authorized Official Name and Position | Sornya Ponrartana (MD) |
| Authorized Official Contact | 7148396611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sornya Ponrartana Md Inc 3526 W 1st St Santa Ana CA 92703-3302 Ph: (714) 839-6611 | Sornya Ponrartana Md Inc 3526 W 1st St Santa Ana CA 92703-3302 Ph: (714) 839-6611 |
| NPI Number | 1710247085 |
|---|---|
| Provider Enumeration Date | 05/21/2012 |
| Last Update Date | 05/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710247085 | NPI | - | NPPES |
| 1567039 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A102825 (California) | Primary |
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