Souksavong, Bounlath Kent

Souksavong, Bounlath Kent is an individual health care provider with primary practice located at 847 W Childs Ave , Merced CA 95341-6862. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Souksavong, Bounlath Kent can be contacted via phone (209) 383-7441.

Contact Information

Primary practice address
847 W Childs Ave Merced CA 95341-6862
Phone: (209) 383-7441
Fax: (209) 383-1643
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA12844 California

Profile Details

NPI number 1326021171
LBN Legal business name Souksavong, Bounlath Kent
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 25th, 2005
Last updated Mar 7th, 2023 - about 3 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 1326021171 NPPES
California Other 1022633 NCCPA CERT #

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