Provider Demographics
NPI:1841770781
Name:SOUNG, VANNA
Entity Type:Individual
Prefix:
First Name:VANNA
Middle Name:
Last Name:SOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GINAH
Other - Middle Name:
Other - Last Name:SOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9455 CLAIRMONTMESA BLVD
Mailing Address - Street 2:RESPIRATORY DEPT
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:858-266-4200
Mailing Address - Fax:
Practice Address - Street 1:9455 CLAIRMONTMESA BLVD
Practice Address - Street 2:RESPIRATORY DEPT
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-266-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27754227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered