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Individual

DR. EKAMOL TANTISATTAMO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 THE CITY DR S BLDG 30, ORANGE, CA 92868-3201
(714) 456-7720
Mailing address
200 S MANCHESTER AVE STE 300, ORANGE, CA 92868-3219
(714) 456-2986

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5680
HI
207RN0300X
Nephrology Physician
Primary
A151885
CA

Other

Enumeration date
06/18/2009
Last updated
03/30/2023
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