Andrew Phetaroun Somphonphakdy

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

Practice address

13229 Edwards Rd
La Mirada, CA 90638-1823

Phone

(562) 587-0978

NPI assigned

Nov 7, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1636243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636243200000",
    "number": "1225793987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13229 EDWARDS RD",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381823",
            "telephone_number": "562-587-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13229 EDWARDS RD",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381823",
            "telephone_number": "562-587-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMPHONPHAKDY",
        "first_name": "ANDREW",
        "middle_name": "PHETAROUN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-07",
        "last_updated": "2021-11-07",
        "certification_date": "2021-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Lauren Smith, D.C.
• Stephen Carroll Smith, DC
• Joon Woo Sohn, DMD
• Jonah Solomon, DNP
• Maria Celine Isabel Sombillo
• Seok Mo Son
• Seoyoun Song
• Adriana Belen Sosa Contreras
• Mariana Sosa
• Southern California Immediate Medical Center

• Occupational Therapy Assistant in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Occupational Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; 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.