Plong, Austin Vannath

Plong, Austin Vannath is an sole proprietor health care provider with primary practice located at 2661 E Florence Ave Suite D-1, Huntington Park CA 90255-4793. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Plong, Austin Vannath can be contacted via phone (323) 588-6113.

Contact Information

Primary practice address
2661 E Florence Ave Suite D-1 Huntington Park CA 90255-4793
Phone: (323) 588-6113
Fax: (323) 588-6468
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 15560 California

Profile Details

NPI number 1366622433
LBN Legal business name Plong, Austin Vannath
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 6th, 2007
Last updated Nov 6th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366622433 NPPES
California MEDICAID GR0100930

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