VILA PHOULAVAN

BERKELEY, CA
NPI1184705212
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: CA  17855)
Enumeration Date2006-10-17
Last Update Date2024-10-30
Business Address
VILA PHOULAVAN PA-C
2500 MILVIA ST
BERKELEY, CA 94704-2636
Phone number: 510-204-5514
Mailing Address
VILA PHOULAVAN PA-C
6220 FAIRLANE DR UNIT B
OAKLAND, CA 94611-1810
Phone number: 510-735-1891
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