Individual provider Active NPI

Chadchadin Nonghin

  • Certified Registered Nurse Anesthetist
  • Los Angeles, CA
National Provider Identifier
1396269338
Registry record updated Jul 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95000820 Issued in CA
Practice address
1500 San Pablo St
Los Angeles, CA 90033-5313
Phone
(323) 442-7400
NPI assigned
Aug 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 792212 CA
Certified Registered Nurse Anesthetist 367500000X NA95000820 CA Primary

Addresses

Primary practice location

1500 San Pablo St
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-7400

Other practice location 1

10935 Milano Ave
Norwalk, CA 90650-1639
Phone (714) 220-8967

Other practice location 2

10935 Milano Ave
Norwalk, CA 90650-1639
Phone (714) 220-8967

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171215001463 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6103184379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

6640 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6650 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6670 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
792212CAMDRegistered Nurse
95000820CAMDFamily Nurse Practitioner
NA95000820CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 12, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 12, 2018 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657929600000",
    "number": "1396269338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10935 Milano Ave",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906501639",
            "country_code": "US",
            "telephone_number": "714-220-8967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10935 Milano Ave",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906501639",
            "country_code": "US",
            "telephone_number": "714-220-8967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NONGHIN",
        "first_name": "CHADCHADIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-01",
        "last_updated": "2022-07-16",
        "certification_date": "2022-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "792212",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95000820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.