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Andrew Tantisukarom
NPI 1407765837 · on the registry since 2026 · sole proprietor
Practice
- Address
- 2805 Abbot Kinney Blvd
Venice, CA 90291 - Phone
- (323) 683-5074
Registry record
- Primary taxonomy
- 225700000X
225700000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-09-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California