Thida Tep Kong
Technician, Other in San Francisco, CA. Individual provider (NPI-1).
NPI number1346837101
StatusActive
Last updated in NPPESDec 28, 2020
Details
- NPI
- 1346837101
- Entity type
- Individual (NPI-1)
- Name
- Thida Tep Kong
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 28, 2020
- Certification date
- Dec 28, 2020
- Last updated
- Dec 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
795 Folsom St Fl 1San Francisco, CA 94107-4226
Phone 855-832-6727
Mailing address
2532 Robin CtUnion City, CA 94587-3152
Phone 415-407-9974
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