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Kandavin Thong
Family Nurse Practitioner in Banning, California
NPI 1609457753

Kandavin Thong is a Family Nurse Practitioner based in San Bernardino, CA and is specialized in Family. Kandavin Thong practices in Banning, CA. The NPI Number for Kandavin Thong is 1609457753 and holds a License No. 95022634 (California).

The current practice location address for Kandavin Thong is 6109 W Ramsey St, Banning, CA and can be reached out via phone at 951-845-0313.

Location: 6109 W Ramsey St, Banning, CA, 92423-0069
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1609457753
Provider Name
Kandavin Thong
Credential
Provider Entity Type
Individual
Gender
Female
Address
6109 W Ramsey St, Banning, CA, 92423-0069
Phone Number
951-845-0313
Fax Number
Provider Enumeration Date
04/20/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
6109 W Ramsey St
City
Banning
State
California
Zip
92220-3051
Phone Number
951-845-0313
Fax Number
person
Provider Business Mailing Address Details
Address
6109 W Ramsey St
City
Banning
State
California
Zip
92220-3051
Phone Number
951-845-0313
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
95022634 (California)
Definition
Definition to come...
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