Provider Demographics
NPI:1194047175
Name:TOKUMI, SARUNTORN
Entity type:Individual
Prefix:
First Name:SARUNTORN
Middle Name:
Last Name:TOKUMI
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 1:2671 N LAS VEGAS BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-5807
Mailing Address - Country:US
Mailing Address - Phone:702-649-3529
Mailing Address - Fax:702-642-5102
Practice Address - Street 1:2671 N LAS VEGAS BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5807
Practice Address - Country:US
Practice Address - Phone:702-649-3529
Practice Address - Fax:702-642-5102
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist