Individual
DR. SOMSUPHA KANJANAUTHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1300 N VERMONT AVE, LOS ANGELES, CA 90027-6098
(323) 913-4200
(510) 281-0766
Mailing address
1300 N VERMONT AVE, LOS ANGELES, CA 90027-6098
(323) 913-4200
(510) 281-0766
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A103083
CA
207RC0000X
Cardiovascular Disease Physician
22647
WI
207RC0000X
Cardiovascular Disease Physician
A103083
CA
207RI0011X
Interventional Cardiology Physician
Primary
A103083
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201073310A
—
KS
Enumeration date
05/21/2007
Last updated
07/25/2023
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