Individual provider · Type 1 NPI

Andrew Tantisukarom

Massage Therapist · Venice, CA

NPI number 1407765837 Active

Practice location

2805 Abbot Kinney Blvd
Venice, CA 90291-6722

Call (323) 683-5074 Map

Mailing address

809 N Orlando Ave
West Hollywood, CA 90069-5413

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X82023 (CA)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1407765837

Andrew Tantisukarom's National Provider Identifier is 1407765837, issued on Sep 2, 2026. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Venice, CA. The record was last updated on Sep 2, 2026.