Provider Demographics
NPI:1053552604
Name:TONGBAI, DANIEL SOMPOJ (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SOMPOJ
Last Name:TONGBAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 WESTWOOD PLAZA RM 3325
Mailing Address - Street 2:RONALD REAGAN UCLA MED CTR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7403
Mailing Address - Country:US
Mailing Address - Phone:310-319-2241
Mailing Address - Fax:310-319-2263
Practice Address - Street 1:1245 16TH ST STE 225
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1240
Practice Address - Country:US
Practice Address - Phone:310-319-2241
Practice Address - Fax:310-319-2263
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94582207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology