Individual provider Active NPI

Tippawon Chaibang

  • Massage Therapist
  • North Hollywood, CA
National Provider Identifier
1063015360
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
75623 Issued in CA
Practice address
7937 Vantage Ave
North Hollywood, CA 91605-2411
Phone
(818) 423-6982
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 75623 CA Primary

Addresses

Primary practice location

7937 Vantage Ave
North Hollywood, CA 91605-2411

Mailing address

7937 Vantage Ave
North Hollywood, CA 91605-2411
Phone (818) 423-6982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
75623CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1063015360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7937 VANTAGE AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052411",
            "telephone_number": "818-423-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7937 VANTAGE AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916052411",
            "telephone_number": "818-423-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIBANG",
        "first_name": "TIPPAWON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "75623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.