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General NPI Number Information
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NPI Number | 1497830962
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Entity Type | Individual
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Provider Name | MICHAEL AUNGKHIN REGISTERED NURSE
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 11/11/2009
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Provider Practice Location Address
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Address Line | 3840 MYERS ST 2ND FLR.
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City | RIVERSIDE
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State | CA
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Zip | 92503-3614
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Country | US
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Telephone | 951-358-7718
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Fax | 951-358-7720
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Provider Business Mailing Address
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Address Line | 18502 STALLION CREST RD
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City | RIVERSIDE
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State | CA
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Zip | 92504-9614
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Country | US
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Telephone | 951-536-0585
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 201773
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 756959
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License Number State | CA
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