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Individual
THAVINSAKDI VIRAVATHANA
Active
Individual
THAVINSAKDI VIRAVATHANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
A34942
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A349420
—
CA
01
—
00A349421
MEDICARE PTAN
—
01
—
00A349422
MEDICARE PTAN
—
01
—
300127206
RAILROAD
CA
Enumeration date
06/16/2006
Last updated
02/28/2013
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