Wattanamano, Pornthep
Wattanamano, Pornthep is an individual health care provider with primary practice located at 3335 Riviera Dr , San Diego CA 92109-6614. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Wattanamano, Pornthep can be contacted via phone (713) 384-3229.Contact Information
Primary practice address
3335 Riviera Dr
San Diego CA 92109-6614
Phone: (713) 384-3229
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | C186338 | California |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | C186338 | California |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | L5950 | Texas |
Profile Details
| NPI number | 1295738516 |
|---|---|
| LBN Legal business name | Wattanamano, Pornthep |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2005 |
| Last updated | Sep 29th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295738516 | NPPES |
| Texas | MEDICAID | 157125902 | |
| Texas | Other | P00193508 | |
| Texas | Other | 8R0570 |
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