Provider Demographics
NPI:1265793798
Name:SIENG, VOUCHMENG
Entity type:Individual
Prefix:
First Name:VOUCHMENG
Middle Name:
Last Name:SIENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 E COLUMBIA ST
Mailing Address - Street 2:201 & 6
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1620
Mailing Address - Country:US
Mailing Address - Phone:562-276-3650
Mailing Address - Fax:562-933-0487
Practice Address - Street 1:455 E COLUMBIA ST
Practice Address - Street 2:201 & 6
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1620
Practice Address - Country:US
Practice Address - Phone:562-276-3650
Practice Address - Fax:562-933-0487
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC11466FOtherMEDICAL