Provider Demographics
NPI:1740808138
Name:SRISILTANANON, RUJIREG
Entity type:Individual
Prefix:MRS
First Name:RUJIREG
Middle Name:
Last Name:SRISILTANANON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23334 VALENCIA BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1712
Mailing Address - Country:US
Mailing Address - Phone:661-568-9111
Mailing Address - Fax:
Practice Address - Street 1:23334 VALENCIA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-1712
Practice Address - Country:US
Practice Address - Phone:661-568-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-11
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Rehabilitation