Individual
WIPUSIT TAESOMBAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
521 PARNASSUS AVE, C-341, SAN FRANCISCO, CA 94143-2206
(415) 476-0762
Mailing address
301 JUDAH ST, APT# 203, SAN FRANCISCO, CA 94122-2456
(415) 758-8681
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F387
CA
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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