Individual provider · Type 1 NPI

Bounlath Kent Souksavong, PA

Medical Physician Assistant · Merced, CA

NPI number 1326021171 Active

Practice location

847 W Childs Ave
Merced, CA 95341-6862

Call (209) 383-7441 Map

Fax (209) 383-1643

Mailing address

737 W Childs Ave
Merced, CA 95340-6805

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA12844 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1326021171

Bounlath Kent Souksavong, PA's National Provider Identifier is 1326021171, issued on Nov 25, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Merced, CA. The record was last updated on Mar 7, 2023.