| Davon Phomvongsa, | |
|
2122 Corte Plata Espuela, Alpine, CA 91901-3184 | |
| (619) 659-0966 | |
| Not Available |
| Full Name | Davon Phomvongsa |
|---|---|
| Gender | Female |
| Speciality | Licensed Vocational Nurse |
| Location | 2122 Corte Plata Espuela, Alpine, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538321534 | NPI | - | NPPES |
| 92543753A65053 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164X00000X | Licensed Vocational Nurse | VN185979 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Davon Phomvongsa, 12617 Lindo Ln, Unit C, Lakeside, CA 92040-4267 Ph: (619) 851-8012 | Davon Phomvongsa, 2122 Corte Plata Espuela, Alpine, CA 91901-3184 Ph: (619) 659-0966 |
Miss Jodi Marie Culligan, LVN Licensed Vocational Nurse Medicare: Not Enrolled in Medicare Practice Location: 1539 Tavern Rd Apt 123, Alpine, CA 91901 Phone: 858-603-2492 | |
Mr. Robert Joseph Hoffman Jr., Licensed Vocational Nurse Medicare: Not Enrolled in Medicare Practice Location: 2122 Corte Plata Espuela, Alpine, CA 91901 Phone: 619-659-0966 |