Individual
DR. VRIJESH SHANTANU TANTUWAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12630 MONTE VISTA RD, SUITE 105, POWAY, CA 92064-2530
(858) 312-5016
(858) 312-5018
Mailing address
13029 POMERADO RD STE B, POWAY, CA 92064-4246
(858) 312-5016
(858) 312-5018
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
A79530
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45688
MEDICAL LICENSE
AZ
Enumeration date
06/17/2005
Last updated
02/12/2026
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