PHALLA OUK


Address: 2215 Lydia Bradley St, Stockton, CA 95206-6135
Phone: 2094233952

PHALLA OUK (NPI# 1912395906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912395906
Entity Type Individual
Full Name PHALLA OUK
Credential RN
Practice Address 2215 Lydia Bradley St
Stockton
CA 95206-6135
Practice Telephone 2094233952
Mailing Telephone 2094233952
Enumeration Date 2014-12-29
Last Update Date 2014-12-29
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WI0500X Registered Nurse
Specialization: Infusion Therapy
719534 CA Nursing Service Providers

Office Location

Street Address 2215 LYDIA BRADLEY ST
City STOCKTON
State CA
Zip Code 95206-6135

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Taxonomy Information

Taxonomy Code 163WI0500X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Infusion Therapy

Taxonomy Definition

Definition to come...

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Competitor

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City STOCKTON
Zip Code 95206

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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