Individual
BEN KAVOUSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PA-C
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-5252
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-5252
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
KO000629
PA
363A00000X
Physician Assistant
Primary
52383
CA
363A00000X
Physician Assistant
OA003526
PA
Other
Enumeration date
04/03/2015
Last updated
11/01/2017
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