Provider Demographics
NPI:1518014398
Name:HUNRO, SOKAN L (PA)
Entity Type:Individual
Prefix:MR
First Name:SOKAN
Middle Name:L
Last Name:HUNRO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5644 HAYTER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-1607
Mailing Address - Country:US
Mailing Address - Phone:909-800-5527
Mailing Address - Fax:
Practice Address - Street 1:6246 DESCANSO AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-1013
Practice Address - Country:US
Practice Address - Phone:714-522-9794
Practice Address - Fax:714-522-9701
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12279363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical