Individual
SAMANTHA TANGCHAIBURANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 UCLA MEDICAL PLZ STE 100, LOS ANGELES, CA 90024-7000
(310) 481-7545
(310) 497-9070
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(301) 758-9683
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
758670
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
95001107
CA
Other
Enumeration date
08/19/2014
Last updated
12/19/2019
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