Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sururat A Coulibaly, PA-C

Individual provider Medical Physician Assistant · NPI 1235427816

Sururat A Coulibaly, PA-C is a Medical Physician Assistant in Las Vegas, Nevada. Licensed in California and Nevada. Registered with an NPI since 2011.

Licensed in
CA, NV
In the registry since
2011
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

630 S Rancho Dr Ste E
Las Vegas, NV 89106-4849
Phone: (702) 258-1001
Fax: (702) 258-3455
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA1271 (NV)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA21484 (CA)

Record details

NPI number1235427816
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 15, 2011
Last updated in NPPESNovember 2, 2021
Certification dateNovember 2, 2021

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