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NPI Code Detail

MEDICARE: SAYUDHARISTA SUMANTRI

MEDICARE: SAYUDHARISTA SUMANTRI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation Specialist
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1568260727
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAYUDHARISTA SUMANTRI
Provider Business Mailing Address
First Line : 3303 N BROADWAY FL 4
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-2803
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3303 N BROADWAY FL 4
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-2803
Country : US
Telephone Number : 213-308-4467
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2025
Last Update Date : 02/26/2026

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Directions to “ SAYUDHARISTA SUMANTRI ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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