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General NPI Number Information
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NPI Number | 1366365132
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Entity Type | Individual
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Provider Name | MRS. PHORNNATCHA SONGKAEW
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Gender | Female
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 4640 DEL AMO BLVD
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City | TORRANCE
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State | CA
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Zip | 90503-1939
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Country | US
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Telephone | 310-800-1418
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 CENTER DR APT 557
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City | LOS ANGELES
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State | CA
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Zip | 90045-8935
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Country | US
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Telephone | 626-654-2456
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 66341
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License Number State | CA
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