Individual provider Active NPI

Nora Hongsdusit Haripotepornkul, M.D.

  • Obstetrics & Gynecology Physician
  • San Diego, CA
National Provider Identifier
1164678322
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A101038 Issued in CA
Practice address
17140 Bernardo Center Dr
Suite 100
San Diego, CA 92128-2093
Phone
(800) 290-5000
NPI assigned
Aug 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A101038 CA Primary

Addresses

Primary practice location

17140 Bernardo Center Dr
Suite 100
San Diego, CA 92128-2093

Mailing address

10414 Duxbury LN Unit 12
San Diego, CA 92127-6879
Phone (858) 449-8481

Other names 1

  • Nora Hongsdusit Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000099 CA Practitioner - Obstetrics/Gynecology 6709065808 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A101038CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 26, 2010 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 26, 2010 Accepting new patients

Locations

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

17140 Bernardo Center Dr
Ste 100
San Diego, CA 92128

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1164678322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10414 DUXBURY LN UNIT 12",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921276879",
            "telephone_number": "858-449-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17140 BERNARDO CENTER DR",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282093",
            "telephone_number": "800-290-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARIPOTEPORNKUL",
        "first_name": "NORA",
        "middle_name": "HONGSDUSIT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A101038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NORA",
            "last_name": "HONGSDUSIT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.