Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Andrew Tantisukarom

Individual provider Massage Therapist · NPI 1407765837

Andrew Tantisukarom is a Massage Therapist in Venice, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2026
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Practice location Address checks out

2805 Abbot Kinney Blvd
Venice, CA 90291-6722
Phone: (323) 683-5074
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 82023 (CA)

Record details

NPI number1407765837
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 2, 2026
Last updated in NPPESSeptember 2, 2026
Certification dateSeptember 2, 2026

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