Soung, Jerry

Soung, Jerry is an sole proprietor health care provider with primary practice located at 1610 N El Dorado St Suite 17, Stockton CA 95204-5930. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Soung, Jerry can be contacted via phone (209) 465-5107.

Contact Information

Primary practice address
1610 N El Dorado St Suite 17 Stockton CA 95204-5930
Phone: (209) 465-5107
Fax: (209) 465-7653
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A73550 California
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X A73550 California

Profile Details

NPI number 1154318764
LBN Legal business name Soung, Jerry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 29th, 2005
Last updated Jul 8th, 2007 - about 17 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 1154318764 NPPES
California MEDICAID 00A735500

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