BOUNLATH KENT SOUKSAVONG PA - NPI 1326021171 - Physician Assistant in Merced, CA

Q: What is Bounlath Souksavong's NPI number?

The NPI number for Bounlath Souksavong is 1326021171. It was assigned to this individual provider in the NPPES registry on November 25, 2005.

Q: What is Bounlath Souksavong's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

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About Bounlath Kent Souksavong Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOUNLATH KENT SOUKSAVONG PA (NPI 1326021171) is an individual medical provider in Merced, California, licensed in California (PA12844) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1326021171

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameBOUNLATH KENT SOUKSAVONGCredential: PA

Location Address847 W CHILDS AVEMerced, CA 95341-6862

Mailing Address737 W Childs AveMerced, CA 95340-6805 · (209) 383-1848 · Fax (209) 383-1296

Phone(209) 383-7441

Fax(209) 383-1643

Sole ProprietorNo

Enumeration DateNovember 25, 2005

Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration

✔ NPI 1326021171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · PA12844

847 W CHILDS AVE, Merced, CA 95341

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Other Identifiers 1

Other1022633CA · Nccpa Cert #

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CESAR GARCIA LCSW

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