Individual
BUNSRI THANASOPHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
285 EAST 24TH STREET, UPLAND, CA 91784
(909) 946-8213
(909) 946-8213
Mailing address
285 E. 24TH STREE, UPLAND, CA 91784
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A29667
CA
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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