Sophia Nechama Antoun, PA-C
Physician Assistant in Fremont, CA. Individual provider (NPI-1).
NPI number1205513645
StatusActive
Last updated in NPPESJan 15, 2025
Details
- NPI
- 1205513645
- Entity type
- Individual (NPI-1)
- Name
- Sophia Nechama Antoun
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 28, 2023
- Certification date
- Jan 15, 2025
- Last updated
- Jan 15, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA65514 | CA | Yes |
Practice location
2000 Mowry AveFremont, CA 94538-1716
Phone 510-818-7200
Mailing address
1706 El Camino Real Ste 101Menlo Park, CA 94027-4110
Phone 415-420-3828
Other practice locations
947 Boranda Ave Apt 1
Mountain View, CA 94040-2639
Mountain View, CA 94040-2639
Phone 415-420-3828
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