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BOONSONG ANAN M.D.

>> Urology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1639189020

Individual Registrant:
 BOONSONG  ANAN M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
5365 WALNUT AVE SUITE P CHINO, CA 91710-2622 US
Tel: 909-627-8521  Fax: 909-563-8202

Contact information for business:
5365 WALNUT AVE SUITE P CHINO, CA 91710-2622 US
Tel: 909-627-8521  Fax: 909-563-8202

Registration Information:
NPI: 1639189020
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208800000XAllopathic & Osteopathic Physicians
Urology
CAA316890

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
A316890CA05




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