SOPHAVY SUON


Address: 11611 San Vicente Blvd Lbby Level, Los Angeles, CA 90049-5106
Phone: 3108200013

SOPHAVY SUON (NPI# 1942738943) 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) 1942738943
Entity Type Individual
Full Name SOPHAVY SUON
Credential PA-C
Practice Address 11611 San Vicente Blvd Lbby Level
Los Angeles
CA 90049-5106
Mailing Address 3360 E Foothill Blvd Apt 104
Pasadena
CA 91107-6049
Practice Telephone 3108200013
Mailing Telephone 9792998872
Enumeration Date 2017-06-02
Last Update Date 2017-06-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
54512 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 11611 SAN VICENTE BLVD LBBY LEVEL
City LOS ANGELES
State CA
Zip Code 90049-5106

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NPI Name Taxonomy Address Enumeration
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1851864946 Christie Schnur Marriage & Family Therapist 11911 San Vicente Blvd., Los Angeles, CA 90049 2019-01-10
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1972090710 Community Reflections Inc Counselor 10020 So. Western Ave, 10020 So. Western Ave, Los Angeles, CA 90049 2018-04-17
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1295240679 Robert A Brooks Preventive Medicine 149 South Barrington Ave, #346, Los Angeles, CA 90049 2017-12-07
1598286478 Marvin S Serrano Physical Therapy Assistant 11740 San Vicente Boulevard Suite 205, Los Angeles, CA 90049 2017-06-30
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1386115137 Sonya Lorain Earley Physician Assistant 2020 Zonal Avenue, Ird 626, Los Angeles, CA 90033 2018-12-05
1619429503 Rachel Frankenthal Physician Assistant 200 Medical Plz Ste 220, Ucla Department of Obgyn, Los Angeles, CA 90095-0001 2016-10-26
1982152815 Accessmed A Physician Assistant Professional Corporation Physician Assistant 1055 W 7th St Fl 33, Los Angeles, CA 90017-2577 2016-09-20
1043766363 Amber Joy Rangel Physician Assistant 2523 Armacost Ave, Los Angeles, CA 90064-2715 2016-08-28
1184080459 Doreen Yasharel Physician Assistant 824 S Wooster St Apt 306, Los Angeles, CA 90035-1745 2016-01-02
1649649443 Thuy Vo Physician Assistant 5841 Bowcroft St, Unit 2, Los Angeles, CA 90016-4955 2015-09-22
1649655663 Carlee Ettinger Physician Assistant 2751 Rinconia Dr, Los Angeles, CA 90068-2227 2015-07-21
1841681467 Lauren Layson Physician Assistant 4049 Via Marisol, Los Angeles, CA 90042-5055 2015-02-18
1871981282 Dianne Desiree Rivera Navoa Physician Assistant 8631 W 3rd St Ste 1035e, Los Angeles, CA 90048-5964 2015-01-07
1093112351 Baypointe Medical Group Physician Assistant 1010 Wilshire Blvd Apt 112, Los Angeles, CA 90017-5663 2014-12-01
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Competitor

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City LOS ANGELES
Zip Code 90049

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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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