BOUNLATH KENT SOUKSAVONG PA NPI 1326021171

NPI Information

NPI: 1326021171
Provider Name: BOUNLATH KENT SOUKSAVONG, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
847 W CHILDS AVE
MERCED, CA
ZIP 95341
Phone: (209) 383-7441
Get Directions

Bounlath Kent Souksavong, PA is a medical physician assistant in Merced, CA. Bounlath Kent Souksavong, PA NPI is 1326021171. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

847 W CHILDS AVE
MERCED, CA
ZIP 95341-862
Phone: (209) 383-7441
Fax: (209) 383-1643

The enumeration date for this NPI number is 11/25/2005 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA12844	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1022633	OTHER	CALIFORNIA	NCCPA CERT #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »