Individual
JUTHAMAS KOSITSAWAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11370 ANDERSON ST, LOMA LINDA, CA 92354
(909) 558-2806
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-4701
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A139735
CA
Other
Enumeration date
04/17/2014
Last updated
09/24/2018
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