DAN VONGTAMA M.D.
Individual Provider (NPI-1)
Active
Provider Information
- NPI Number
1245434083- Provider Type
- Individual Provider (NPI-1)
- Credentials
- M.D.
- Status
- Active
Contact & Location
- Address
- 4722 QUAIL LAKES DR, STOCKTON, CA, 952075256
- Phone
- (209) 472-1848
- Fax
- (209) 472-0133
Specialties & Taxonomies
Unknown
Primary License: CA #A109003
All Addresses
MAILING
4722 QUAIL LAKES DR
STOCKTON, CA, 952075256