Most Relevant Information
Provider Data
| NPI Number: | 1003599952 |
| Provider Name: | SUCHADA TACHASOOKSAREE |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/08/2023 |
| Last Updated: | 08/14/2023 |
Provider Practice Location
309 E 2ND ST
POMONA
CA
917661854
Practice Location Phone/Fax
| Phone: | 6265385371 |
| Fax: |
Provider Mailing Location
1901 E LAMBERT RD STE 102
LA HABRA
CA
906315757
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |