Most Relevant Information
Provider Data
| NPI Number: | 1003234717 |
| Provider Name: | MELANIE KUSONRUKSA M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 207L00000X |
| Specialty: | Anesthesiology |
| License Number: | A139310 |
Most Important Dates
| Enumeration Date: | 03/31/2014 |
| Last Updated: | 05/06/2022 |
Provider Practice Location
1500 SAN PABLO ST
LOS ANGELES
CA
900335313
Practice Location Phone/Fax
| Phone: | 3234427400 |
| Fax: |
Provider Mailing Location
PO BOX 31309
LOS ANGELES
CA
900310309
Provider Mailing Phone/Fax
| Phone: | 3234427400 |
| Fax: |