Most Relevant Information
Provider Data
| NPI Number: | 1003529447 |
| Provider Name: | TIPPHAWAN WANNAPRAPHA LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164X00000X |
| Specialty: | Licensed Vocational Nurse |
| License Number: | 711749 |
Most Important Dates
| Enumeration Date: | 12/30/2022 |
| Last Updated: | 12/30/2022 |
Provider Practice Location
7515 VAN NUYS BLVD
VAN NUYS
CA
914051949
Practice Location Phone/Fax
| Phone: | 8186273000 |
| Fax: |
Provider Mailing Location
7515 VAN NUYS BLVD
VAN NUYS
CA
914051949
Provider Mailing Phone/Fax
| Phone: | 8186273000 |
| Fax: |