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Individual
THOMAS BOUASY
Active
Individual
THOMAS BOUASY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17818
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AO427X
MEDICARE PTAN-URGENT CARE
CA
01
—
AO427Y
MEDICARE PTAN-TRUXTUN
CA
01
—
AO427Z
MEDICARE PTAN-SOUTHWEST
CA
05
—
PA17818
—
CA
Enumeration date
01/13/2006
Last updated
05/10/2011
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