Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 95005472 | CA |
NPI | 1003268434 |
---|---|
Provider Name | Chio Saephanh |
First Address | Merced, CA 95340 |
Second Address | Merced, CA 95340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2016 |
Last Update Date | 28/12/2018 |