Provider Demographics
NPI:1891883955
Name:PONHOLD, SIEGHART H (MD)
Entity Type:Individual
Prefix:DR
First Name:SIEGHART
Middle Name:H
Last Name:PONHOLD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13132 STUDEBAKER RD
Mailing Address - Street 2:STE 10
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2576
Mailing Address - Country:US
Mailing Address - Phone:562-470-7500
Mailing Address - Fax:562-470-7551
Practice Address - Street 1:13132 STUDEBAKER RD
Practice Address - Street 2:STE 10
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2576
Practice Address - Country:US
Practice Address - Phone:562-474-8877
Practice Address - Fax:562-474-8879
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2018-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA35148207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA27693Medicare UPIN