Nuttachai Thanaethanapong

Primary specialty

PharmacistTaxonomy code 183500000X

License

42808 Issued in CA

Practice address

19424 Soledad Canyon Rd
Canyon Country, CA 91351-2631

Phone

(661) 251-5444

NPI assigned

Apr 16, 2019

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

Other identifiers 2

Other names 1

• Mr. Nat Thanaet Other name

Electronic endpoints 2

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": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1366005266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19424 SOLEDAD CANYON RD",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913512631",
            "telephone_number": "661-251-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19424 SOLEDAD CANYON RD",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913512631",
            "telephone_number": "661-251-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANAETHANAPONG",
        "first_name": "NUTTACHAI",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "42808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "42808",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "RPH42808",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Pharmacy",
            "affiliation": "N",
            "endpointDescription": "Pharmacy",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Pharmacy",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pharmacy",
            "address_1": "19424 Soledad Canyon Rd",
            "city": "Canyon Country",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913512631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pharmacy",
            "affiliation": "N",
            "endpointDescription": "Pharmacy",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Pharmacy",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pharmacy",
            "address_1": "19424 Soledad Canyon Rd",
            "city": "Canyon Country",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913512631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NAT",
            "last_name": "THANAET",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Top Function

• Pharmacist in Canyon Country, CA
• Providers in Canyon Country, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.