Organization Active NPI

Dumrong Tangchitnob MD Inc

  • Obstetrics & Gynecology Physician
  • West Covina, CA
National Provider Identifier
1295834695
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A42027 Issued in CA
Legal business name
DUMRONG TANGCHITNOB MD INC
Practice address
1135 S Sunset Ave
Ste. #102
West Covina, CA 91790-3937
Phone
(626) 338-5377
Fax
(626) 851-8822
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Authorized official

Name
Dr. Dumrong Tangchitnob, M.D.NPI 1487752374
Title
President
Phone
(626) 338-5377

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X A42027 CA Primary

Addresses

Primary practice location

1135 S Sunset Ave
Ste. #102
West Covina, CA 91790-3937

Mailing address

1135 S Sunset Ave
Ste. #102
West Covina, CA 91790-3937
Phone (626) 338-5377

Other identifiers 1

IdentifierTypeStateIssuer
00A420270MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090113000785 CA Part B Supplier - Clinic/Group Practice 4880757111 Receives reassigned benefits from 2 practitioners
Practice locations: West Covina, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1295834695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE",
            "address_2": "STE. #102",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903937",
            "telephone_number": "626-338-5377",
            "fax_number": "626-851-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE",
            "address_2": "STE. #102",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903937",
            "telephone_number": "626-338-5377",
            "fax_number": "626-851-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUMRONG TANGCHITNOB MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "TANGCHITNOB",
        "authorized_official_first_name": "DUMRONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-338-5377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A42027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A420270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.