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General NPI Number Information
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NPI Number | 1053552604
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Entity Type | Individual
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Provider Name | DANIEL SOMPOJ TONGBAI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 1245 16TH ST STE 225
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City | SANTA MONICA
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State | CA
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Zip | 90404-1240
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Country | US
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Telephone | 310-319-2241
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Fax | 310-319-2263
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Provider Business Mailing Address
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Address Line | 757 WESTWOOD PLAZA RM 3325 RONALD REAGAN UCLA MED CTR
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City | LOS ANGELES
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State | CA
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Zip | 90095-7403
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Country | US
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Telephone | 310-319-2241
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Fax | 310-319-2263
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A94582
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License Number State | CA
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