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Individual

DR. BEN TANTAYANUBUTR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
43112 15TH ST W, LANCASTER, CA 93534-6219
(818) 375-2809
Mailing address
43112 15TH ST W, LANCASTER, CA 93534-6219

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A95887
CA

Other

Enumeration date
09/20/2007
Last updated
12/06/2021
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