TANNY TANTIYAVARONG

OAKLAND, CA
NPI1396164109
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: CA  20A14753)
Enumeration Date2014-04-08
Last Update Date2019-10-03
Business Address
TANNY TANTIYAVARONG
1411 E 31ST ST
OAKLAND, CA 94602-1018
Phone number: 510-437-4141
Mailing Address
TANNY TANTIYAVARONG
1411 E 31ST ST
OAKLAND, CA 94602-1018
Phone number:
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