Provider Demographics
NPI:1043753841
Name:KOUNG, SOMAT (MHS)
Entity Type:Individual
Prefix:
First Name:SOMAT
Middle Name:
Last Name:KOUNG
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S GRAND AVE BLDG C213-W
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4434
Mailing Address - Country:US
Mailing Address - Phone:714-567-7406
Mailing Address - Fax:213-383-3146
Practice Address - Street 1:1300 S GRAND AVE BLDG C213-W
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4434
Practice Address - Country:US
Practice Address - Phone:714-567-7406
Practice Address - Fax:714-567-5140
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator