Individual
DR. BOUNGKHONG DAVID VANSOMPHONE
Active
Individual
DR. BOUNGKHONG DAVID VANSOMPHONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9448
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018399
—
NV
01
—
12431
LIC
MT
01
—
C53921
LIC
CA
01
—
DR48601
LIC
CO
Enumeration date
09/22/2006
Last updated
12/23/2010
Update your record
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