Individual
SIRAPHOB CHANSANGAVEJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
99 MONTECILLO RD, SAN RAFAEL, CA 94903-3308
(415) 791-1329
Mailing address
6208 S ROCHEBLAVE ST APT B, NEW ORLEANS, LA 70125-4223
(504) 400-3509
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
337657
LA
Other
Enumeration date
05/28/2020
Last updated
08/13/2024
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