Prakob Bruce Vassantachart MD a Professional Corporation

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G61725 Issued in CA

Legal business name

PRAKOB BRUCE VASSANTACHART MD A PROFESSIONAL CORPORATION

Practice address

18300 Roscoe Blvd
Northridge, CA 91325-4105

Phone

(818) 885-8500

Fax

(818) 715-1722

NPI assigned

Mar 28, 2006

Last updated

May 12, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prakob Vassantahcart, M.D.

Title

Direct Owner

Phone

(818) 888-7815

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1225099526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7001",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913577001",
            "telephone_number": "818-888-7815",
            "fax_number": "818-715-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254105",
            "telephone_number": "818-885-8500",
            "fax_number": "818-715-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAKOB BRUCE VASSANTACHART MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "VASSANTAHCART",
        "authorized_official_first_name": "PRAKOB",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "818-888-7815",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G61725",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G61725",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.