Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | A72219 | CA |
NPI | 1760425383 |
---|---|
Provider Name | Orawan Sitburana |
First Address | Rolling Hills Estates, CA 90274-2431 |
Second Address | El Monte, CA 91731-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 15/11/2012 |