Duangtavan Sourivong

LBN: Duangtavan Sourivong
Duangtavan Sourivong is an health care organization with primary practice located at 3940 Home Ave , San Diego CA 92105-5952. The organization recently has only one registered license in Ambulatory Health Care Facilities / Methadone, which is considered as the primary health care specialty. Duangtavan Sourivong can be contacted via phone (619) 262-8000, or through Stearns, Bobby via phone (619) 262-8000.

Contact Information

Primary practice address
3940 Home Ave San Diego CA 92105-5952
Phone: (619) 262-8000
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Stearns, Bobby MSW
Phone: (619) 262-8000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Methadone 261QM2800X California

Profile Details

NPI number 1285821389
LBN Legal business name Duangtavan Sourivong
DBA Doing business as
Authorized official Stearns, Bobby MSW
Entity Organization
Organization subpart 1 No
Enumeration date Oct 2nd, 2007
Last updated Oct 2nd, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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