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Ly Kong Pheng Jalao
Primary Care Nurse Practitioner in Sacramento, California
NPI 1952884124

Ly Kong Pheng Jalao is a Primary Care Nurse Practitioner based in Fresno, CA and is specialized in Primary Care. Ly Kong Pheng Jalao practices in Sacramento, CA. The NPI Number for Ly Kong Pheng Jalao is 1952884124 and holds a License No. NP95009751 (California).

The current practice location address for Ly Kong Pheng Jalao is 2200 Del Paso Blvd, Sacramento, CA and can be reached out via phone at 916-642-1890.

Location: 2200 Del Paso Blvd, Sacramento, CA, 93727-5814
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952884124
Provider Name
Ly Kong Pheng Jalao
Credential
Provider Entity Type
Individual
Gender
Male
Address
2200 Del Paso Blvd, Sacramento, CA, 93727-5814
Phone Number
916-642-1890
Fax Number
Provider Enumeration Date
09/12/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2200 Del Paso Blvd
City
Sacramento
State
California
Zip
95815-3102
Phone Number
916-642-1890
Fax Number
person
Provider Business Mailing Address Details
Address
2200 Del Paso Blvd
City
Sacramento
State
California
Zip
95815-3102
Phone Number
916-642-1890
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
363LP2300X
License No.
NP95009751 (California)
Definition
Definition to come...
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