Provider Demographics
NPI:1326295619
Name:SANGUANJIN, YOTSAWEE (MD)
Entity Type:Individual
Prefix:
First Name:YOTSAWEE
Middle Name:
Last Name:SANGUANJIN
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 1:125 SIRINDHORN SOI 9 RD
Mailing Address - Street 2:BANGBUMRU BANGPLAD
Mailing Address - City:BANGKOK
Mailing Address - State:BANGKOK
Mailing Address - Zip Code:10700
Mailing Address - Country:TH
Mailing Address - Phone:662-434-2447
Mailing Address - Fax:
Practice Address - Street 1:125 SIRINDHORN SOI 9 RD
Practice Address - Street 2:BANGBUMRU BANGPLAD
Practice Address - City:BANGKOK
Practice Address - State:BANGKOK
Practice Address - Zip Code:10700
Practice Address - Country:TH
Practice Address - Phone:662-434-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5562207R00000X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine