BOUNLATH KENT SOUKSAVONG

MERCED, CA
NPI1326021171
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: CA  PA12844)
Enumeration Date2005-11-25
Last Update Date2023-03-07
Business Address
BOUNLATH KENT SOUKSAVONG PA
847 W CHILDS AVE
MERCED, CA 95341-6862
Phone number: 209-383-7441
Mailing Address
BOUNLATH KENT SOUKSAVONG PA
737 W CHILDS AVE
MERCED, CA 95340-6805
Phone number: 209-383-1848
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