Individual provider · Type 1 NPI
Thana Krisdakumtorn, DPM
Sports Medicine Podiatrist · Palo Alto, CA
NPI number
1487765863
Active
Practice location
795 El Camino Real
Palo Alto, CA 94301-2302
Mailing address
325 Distel Cir
Los Altos, CA 94022-1408
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Sports Medicine Podiatrist Primary | 213ES0000X | E4241 (CA) |
Sports Medicine Podiatrist: Definition to come...
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About NPI 1487765863
Thana Krisdakumtorn, DPM's National Provider Identifier is 1487765863, issued on Aug 31, 2006. The primary taxonomy on file is Sports Medicine Podiatrist (213ES0000X), and the practice location is in Palo Alto, CA. The record was last updated on Mar 4, 2020.