Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 20A-10743 | CA |
NPI | 1043374028 |
---|---|
Provider Name | Dr. Paul Kuy-Seang Ky |
First Address | Fresno, CA 93710-3715 |
Second Address | Fresno, CA 93710-3715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 24/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DM762Z | (02) | CA |