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Organization
STRETTAPON SURIYANIEL, MD. INC
Active
Organization
STRETTAPON SURIYANIEL, MD. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SURIYANIEL STRETTAPON M.D. (OWNER)
(714) 758-9600
Entity
Organization
Contact information
Practice address
1801 W ROMNEYA DR, 305, ANAHEIM, CA 92801-1830
(714) 758-9600
Mailing address
1801 W ROMNEYA DR, 305, ANAHEIM, CA 92801-1830
(714) 758-9600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A65138
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A65138
MEDICAL
CA
01
—
C2772043
CORPORATE NUMBER
CA
01
—
H00705682
BUSINESS LICENSE
CA
Enumeration date
12/21/2006
Last updated
08/22/2020
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