Phokham Sourivanh, PA-C
NPI 1972022762 · Medical Physician Assistant · Pensacola, FL
Phokham Sourivanh, PA-C is a Medical Physician Assistant provider in Pensacola, FL (NPI 1972022762).
Provider details
- NPI number
- 1972022762
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Military Health Care Provider171000000X
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- Camp PendletonApo, AP 92055Phone: (760) 725-1288
- 34800 Bob Wilson DrSan Diego, CA 92134-1098Phone: (619) 532-6400
Registry dates
- Enumerated
- 2017-09-13
- Last updated
- 2025-06-24
- Certified
- 2025-06-24
Frequently asked questions
- What is Phokham Sourivanh's NPI number?
- Phokham Sourivanh's National Provider Identifier (NPI) is 1972022762, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Phokham Sourivanh's specialty?
- Phokham Sourivanh is listed in the NPPES registry with a primary specialty of Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Phokham Sourivanh located?
- Phokham Sourivanh's practice location on file with NPPES is Nmrtc Pensacola 6000 West Highway 98, Pensacola, FL 32512-0001.
- What is Phokham Sourivanh's phone number?
- The practice phone number listed in the NPPES registry for Phokham Sourivanh is (901) 874-6081.
- Is Phokham Sourivanh's NPI active?
- Yes — Phokham Sourivanh's NPI (1972022762) is active in the NPPES registry as of the last update on 2025-06-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.