Thanteraphong, Mikey

Thanteraphong, Mikey is an individual health care provider with primary practice located at 3175 Old Conejo Rd # 200 , Newbury Park CA 91320-2151. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Thanteraphong, Mikey can be contacted via phone (818) 835-7355.

Contact Information

Primary practice address
3175 Old Conejo Rd # 200 Newbury Park CA 91320-2151
Phone: (818) 835-7355
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 95013063 California

Profile Details

NPI number 1437795333
LBN Legal business name Thanteraphong, Mikey
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 26th, 2019
Last updated Feb 6th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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