Individual
KAO YING MOUAVANGSOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
6695 E LANE AVE, FRESNO, CA 93727-5842
(559) 289-4508
(877) 299-6227
Mailing address
6695 E LANE AVE, FRESNO, CA 93727-5842
(559) 430-9706
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1102787
CA
Other
Enumeration date
08/10/2012
Last updated
03/12/2017
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