Andrew Tantisukarom

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

82023 Issued in CA

Practice address

2805 Abbot Kinney Blvd
Venice, CA 90291-6722

Phone

(323) 683-5074

NPI assigned

Sep 2, 2026

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1407765837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 N ORLANDO AVE",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900695413",
            "telephone_number": "323-683-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 ABBOT KINNEY BLVD",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902916722",
            "telephone_number": "323-683-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANTISUKAROM",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "82023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendan Douglas Swart, AMFT
• Meghan Lilyan Swidler, INHC, CIHC
• Devaunshi Dev Tailor, LAC
• Ginny Tal, LCSW
• Marlene Cosette Talley, DDS
• Casey Tarpey, DPT
• Tamar Tashdjian
• Wade Taylor, CADC-CAS
• Maureen J Teefy, AMFT, APCC
• Valerie Hoang Thai, DMD

• Massage Therapist in Venice, CA
• Providers in Venice, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.