Kheawbua, Krittussapon

Kheawbua, Krittussapon is an sole proprietor health care provider with primary practice located at 14030 Chadron Ave Apt 235 , Hawthorne CA 90250-8247. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as his primary health care specialty. Kheawbua, Krittussapon can be contacted via phone (310) 456-4999.

Contact Information

Primary practice address
14030 Chadron Ave Apt 235 Hawthorne CA 90250-8247
Phone: (310) 456-4999
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 85742 California

Profile Details

NPI number 1194473710
LBN Legal business name Kheawbua, Krittussapon
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2022
Last updated Mar 14th, 2022 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1194473710 NPPES
California MEDICAID 54132

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