Active NPI
Nanthida Phattraprayoon, MD
- Pediatrics Physician
- Los Angeles, CA
National Provider Identifier
1073776639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A102019
- Practice address
- 1240 N Mission Rd
L919
Los Angeles, CA 90033-1019 - Phone
- (323) 226-3409
- NPI assigned
- Jul 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A102019 | CA | Primary |
Addresses
Primary practice location
1240 N Mission Rd
L919
Los Angeles, CA 90033-1019
Mailing address
1800 State St Apt 24
South Pasadena, CA 91030-2166
Phone (551) 998-8338
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A102019 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215043200000",
"number": "1073776639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 STATE ST APT 24",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910302166",
"telephone_number": "551-998-8338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 N MISSION RD",
"address_2": "L919",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331019",
"telephone_number": "323-226-3409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHATTRAPRAYOON",
"first_name": "NANTHIDA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-03",
"last_updated": "2008-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A102019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.