Provider Demographics
NPI:1679724231
Name:SOK, PRAKOB SEN (PAC)
Entity Type:Individual
Prefix:MR
First Name:PRAKOB
Middle Name:SEN
Last Name:SOK
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
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Mailing Address - Street 1:5475 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2609
Mailing Address - Country:US
Mailing Address - Phone:909-591-6446
Mailing Address - Fax:909-591-1309
Practice Address - Street 1:5475 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2609
Practice Address - Country:US
Practice Address - Phone:909-591-6446
Practice Address - Fax:909-591-1309
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2010-02-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant