Individual
CHANUWAT M. SUNTALUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1601 MONTE VISTA AVE STE 190, CLAREMONT, CA 91711-6600
(909) 865-9977
(909) 469-2119
Mailing address
1601 MONTE VISTA AVE STE 190, CLAREMONT, CA 91711-6600
(626) 617-9166
(909) 469-2119
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17843
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518158047
—
CA
Enumeration date
08/08/2007
Last updated
02/25/2026
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