Davon Phomvongsa, | |
2122 Corte Plata Espuela, Alpine, CA 91901-3184 | |
(619) 659-0966 | |
Not Available |
Full Name | Davon Phomvongsa |
---|---|
Gender | Female |
Speciality | Licensed Vocational Nurse |
Location | 2122 Corte Plata Espuela, Alpine, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538321534 | NPI | - | NPPES |
92543753A65053 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
164X00000X | Licensed Vocational Nurse | VN185979 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
Davon Phomvongsa, 12617 Lindo Ln, Unit C, Lakeside, CA 92040-4267 Ph: (619) 851-8012 | Davon Phomvongsa, 2122 Corte Plata Espuela, Alpine, CA 91901-3184 Ph: (619) 659-0966 |
Miss Jodi Marie Culligan, LVN Licensed Vocational Nurse Medicare: Not Enrolled in Medicare Practice Location: 1539 Tavern Rd Apt 123, Alpine, CA 91901 Phone: 858-603-2492 | |
Mr. Robert Joseph Hoffman Jr., Licensed Vocational Nurse Medicare: Not Enrolled in Medicare Practice Location: 2122 Corte Plata Espuela, Alpine, CA 91901 Phone: 619-659-0966 |