Provider Demographics
NPI:1194910455
Name:SIENGTHAI PAPALE, BOONCLAIRE (MD)
Entity type:Individual
Prefix:DR
First Name:BOONCLAIRE
Middle Name:
Last Name:SIENGTHAI PAPALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BOONCLAIRE
Other - Middle Name:
Other - Last Name:SIENGTHAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:322 E THOUSAND OAKS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5804
Mailing Address - Country:US
Mailing Address - Phone:888-515-3500
Mailing Address - Fax:
Practice Address - Street 1:393 E WALNUT ST
Practice Address - Street 2:3RD FLOOR - PHRS
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91188-0001
Practice Address - Country:US
Practice Address - Phone:626-405-7914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95288208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics