DUANGTAVAN SOURIVONG

Clinic/Center - Methadone

Active Organization
NPI: 1285821389

Practice Address

3940 HOME AVE
San Diego, CA 92105

Phone: (619) 262-8000

Specialties

Specialty Code Primary License
Clinic/Center - Methadone 261QM2800X Yes -

Frequently Asked Questions

NPI 1285821389 is the National Provider Identifier for DUANGTAVAN SOURIVONG, a Clinic/Center - Methadone provider located in San Diego, CA. This NPI was enumerated on October 2, 2007.

Quick Facts

NPI
1285821389
Type
Organization
Enumerated
Oct 2, 2007
Last Updated
Oct 2, 2007

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