Tiyaamornwong, Kevin

Tiyaamornwong, Kevin is an individual health care provider with primary practice located at 344 E 6Th St , Madera CA 93638-3631. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Tiyaamornwong, Kevin can be contacted via phone (559) 664-4000.

Contact Information

Primary practice address
344 E 6Th St Madera CA 93638-3631
Phone: (559) 664-4000
Fax: (559) 675-5224
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA 17984 California

Profile Details

NPI number 1275672503
LBN Legal business name Tiyaamornwong, Kevin
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Mar 7th, 2023 - about last year

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 1275672503 NPPES
California Other PA 14398 LICENSE

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