Individual
VANG VINCE MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4929 E KINGS CANYON RD, FRESNO, CA 93727-3812
(559) 255-6476
(559) 255-7906
Mailing address
4929 E KINGS CANYON RD, FRESNO, CA 93727-3812
(559) 255-6476
(559) 255-7906
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18492
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA18492
PHYSICIAN ASSISTANT COMMITTEE
CA
Enumeration date
06/12/2008
Last updated
06/12/2008
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