Doctor Name: | SOKO GUSIC |
NPI Number: | 1073672978 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | RC00029930 |
Business Practice Address: | 720 W Court St #8 Pasco, CA - 99301 |
Business Phone Number: | 5095456506 |
Business Fax Number: | 5095460520 |
Mailing Address: | Po Box 1323, 515 West Court St PASCO |
State: | CA |
Postal Code: | 99301 |
Phone Number: | 5095472204 |
Fax Number: | 5095428836 |
NPI Enumeration Date: | 12/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | RC00029930 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |