Individual
DR. BUNDHIT TANTIWONGKOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A103495
CA
390200000X
Student in an Organized Health Care Education/Training Program
57-009559
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A1034950
—
CA
Enumeration date
05/11/2007
Last updated
07/24/2009
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