Phengphavong, Phonmany

Phengphavong, Phonmany is an sole proprietor health care provider with primary practice located at 1688 N Perris Blvd , Perris CA 92571-4709. She recently has only one registered license in Nursing Service Providers / Licensed Vocational Nurse, which is considered as her primary health care specialty. Phengphavong, Phonmany can be contacted via phone (951) 443-2200.

Contact Information

Primary practice address
1688 N Perris Blvd Perris CA 92571-4709
Phone: (951) 443-2200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Vocational Nurse 164X00000X 287603 California

Profile Details

NPI number 1043849847
LBN Legal business name Phengphavong, Phonmany
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 3rd, 2020
Last updated Apr 3rd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043849847 NPPES
California MEDICAID OTHER

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