Individual
DR. SUPHAMAI BUNNAPRADIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 UCLA MEDICAL PLZ STE 565C, LOS ANGELES, CA 90095-1865
(310) 267-2555
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A65633
CA
Other
Enumeration date
01/03/2006
Last updated
09/17/2020
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