Provider Demographics
NPI:1821287798
Name:NANTHASIT, THANONGSAY (DC)
Entity Type:Individual
Prefix:
First Name:THANONGSAY
Middle Name:
Last Name:NANTHASIT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027
Mailing Address - Country:US
Mailing Address - Phone:760-613-0760
Mailing Address - Fax:760-839-3405
Practice Address - Street 1:240 W MISSION AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025
Practice Address - Country:US
Practice Address - Phone:760-294-9744
Practice Address - Fax:760-839-3405
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30650111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor