Individual provider · Type 1 NPI

Athena Marie Keobounnam, PA-C

Surgical Physician Assistant · Fresno, CA

NPI number 1982482816 Active

Practice location

7257 N Fresno St
Fresno, CA 93720-2950

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Surgical Physician Assistant Primary 363AS0400XPA63422 (CA)

Surgical Physician Assistant: Definition to come...

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About NPI 1982482816

Athena Marie Keobounnam, PA-C's National Provider Identifier is 1982482816, issued on Sep 20, 2023. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Fresno, CA. The record was last updated on Nov 13, 2023.