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PONGMAKTHIKRAKSORIVO PATRICK SISOWATH
NPI 1962218560
Physician Assistant - Medical in Santa Fe Springs, CA

Active since December 09, 2024
10425 PAINTER AVE, SANTA FE SPRINGS, CA 90670(562) 906-2685 Get Directions Write a Review

NPPES record last updated: December 9, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Pongmakthikraksorivo Patrick Sisowath NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PONGMAKTHIKRAKSORIVO PATRICK SISOWATH (NPI 1962218560) is an individual medical provider in Santa Fe Springs, California and active in the NPI registry since December 2024.

NPPES Registry Identity

NPI1962218560
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NamePONGMAKTHIKRAKSORIVO PATRICK SISOWATH
Location Address10425 PAINTER AVESanta Fe Springs, CA 90670-3429
Mailing Address12070 Telegraph RdSanta Fe Springs, CA 90670-3771 · (562) 777-7500
Phone(562) 906-2685
Sole ProprietorYes
Enumeration DateDecember 9, 2024
NPPES CertifiedDecember 9, 2024
✔ NPI 1962218560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
10425 PAINTER AVE, Santa Fe Springs, CA 90670
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOS ANGELES CENTERS FOR ALCOHOL AND DRUG ABUSE
Substance Abuse Rehabilitation Facility
10425 PAINTER AVE
SANTA FE SPRINGS, CA 90670
Los Angeles County (562) 906-2685
LUIS ROBERT BARAJAS
Social Worker (Clinical)
10425 PAINTER AVE
SANTA FE SPRINGS, CA 90670
Los Angeles County (562) 906-2685
KATIE WILLKOM
Counselor (Addiction (Substance Use Disorder))
10425 PAINTER AVE
SANTA FE SPRINGS, CA 90670
Los Angeles County (562) 906-2685
HEATHER STEPHENS
Counselor (Addiction (Substance Use Disorder))
10425 PAINTER AVE
SANTA FE SPRINGS, CA 90670
Los Angeles County (562) 906-2685
ZACH PALASEWSKI
Counselor (Addiction (Substance Use Disorder))
10425 PAINTER AVE
SANTA FE SPRINGS, CA 90670
Los Angeles County (562) 906-2685
GARY IANNARELLI
Counselor (Addiction (Substance Use Disorder))
10425 PAINTER AVE
SANTA FE SPRINGS, CA 90670
Los Angeles County (562) 906-2685
FRANCES VALENZUELA
Counselor (Addiction (Substance Use Disorder))
10425 PAINTER AVE
SANTA FE SPRINGS, CA 90670
Los Angeles County (562) 906-2685
ANNETTE WEYAND
Counselor (Addiction (Substance Use Disorder))
10425 PAINTER AVE
SANTA FE SPRINGS, CA 90670
Los Angeles County (562) 906-2685

Frequently Asked Questions

What is Pongmakthikraksorivo Sisowath's NPI number?

The NPI number assigned to this healthcare provider is 1962218560, enumerated as an "individual" on December 09, 2024.

Where is the provider located?

The provider is located at 10425 PAINTER AVE SANTA FE SPRINGS, CA 90670 and the phone number is (562) 906-2685.

What is the provider's specialty?

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.