LY KONG PHENG JALAO

SACRAMENTO, CA
NPI1952884124
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: CA  NP95009751)
Enumeration Date2018-09-12
Last Update Date2018-09-12
Business Address
LY KONG PHENG JALAO
2200 DEL PASO BLVD
SACRAMENTO, CA 95815-3102
Phone number: 916-642-1890
Mailing Address
LY KONG PHENG JALAO
6817 E LANE AVE
FRESNO, CA 93727-5814
Phone number: 209-613-9089
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