Individual provider Active NPI

Thira Kunakorn, MD

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1174697254
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A29554 Issued in CA
Practice address
1120 W la Palma Ave Ste 6
Anaheim, CA 92801-2820
Phone
(714) 776-6930
Fax
(714) 776-3345
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A29554 CA Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A29554 CA

Addresses

Primary practice location

1120 W la Palma Ave Ste 6
Anaheim, CA 92801-2820

Mailing address

1120 W la Palma Ave
#6
Anaheim, CA 92801-2820
Phone (714) 776-6930

Other identifiers 1

IdentifierTypeStateIssuer
A29554OtherCALIFORNIA LICENSE

Other names 1

  • Thirapan Kunakornskul Former name

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
I20120316000252 CA Practitioner - Internal MedicinePractitioner - Endocrinology 4183883788 Practice locations: Anaheim, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A29554CAMDEndocrinology, Diabetes & Metabolism Physician

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174697254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W LA PALMA AVE",
            "address_2": "#6",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012820",
            "telephone_number": "714-776-6930",
            "fax_number": "714-776-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W LA PALMA AVE STE 6",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012820",
            "telephone_number": "714-776-6930",
            "fax_number": "714-776-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNAKORN",
        "first_name": "THIRA",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A29554",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A29554",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "A29554",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THIRAPAN",
            "last_name": "KUNAKORNSKUL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.