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NPI Code Detail

MEDICARE: PORNPIROON CHEYIAM

MEDICARE:   PORNPIROON  CHEYIAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist47725CA

General Provider Information

NPI Number : 1083432561
Entity Type Code : Individual
Provider Name (Legal Business Name) : PORNPIROON CHEYIAM
Provider Business Mailing Address
First Line : 9768 CEDROS AVE
Second Line :
City : PANORAMA CITY
State : CA
Zip : 91402-1027
Country : US
Telephone Number : 661-441-1449
Fax Number :
Provider Business Practice Location Address
First Line : 2307 W OLIVE AVE
Second Line :
City : BURBANK
State : CA
Zip : 91506-2627
Country : US
Telephone Number : 661-441-1449
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2024
Last Update Date : 10/02/2024

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Directions to “ PORNPIROON CHEYIAM ” Practice Location

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