Active NPI
Sakorn Koonopakarn, M.D.
- Anesthesiology Physician
- San Bernardino, CA
National Provider Identifier
1124089792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A37077
- Practice address
- 2101 N Waterman Ave
San Bernardino, CA 92404-4836 - Phone
- (800) 883-7243
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A37077 | CA | Primary |
Addresses
Primary practice location
2101 N Waterman Ave
San Bernardino, CA 92404-4836
Mailing address
210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (800) 883-7243
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A370770 | Medicaid | CA |
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 |
|---|---|---|---|
| A37077 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193097600000",
"number": "1124089792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 N TUSTIN AVE",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927053807",
"telephone_number": "800-883-7243",
"fax_number": "714-647-1245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 N WATERMAN AVE",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924044836",
"telephone_number": "800-883-7243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOONOPAKARN",
"first_name": "SAKORN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2007-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A37077",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A370770",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.