Suttirak Chaiwongkarjohn, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A115809 Issued in CA

Legal business name

SUTTIRAK CHAIWONGKARJOHN, INC.

Practice address

24123 Del Monte Dr Unit 95
Valencia, CA 91355-3819

Phone

(818) 477-4700

NPI assigned

Apr 18, 2017

Last updated

Apr 20, 2017By 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

Dr. Suttirak Chaiwongkarjohn, M.DNPI 1083879084

Title

Ceo

Phone

(818) 477-4700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Suttirak Chaiwongkarjohn

  • Specialist
  • Lancaster, CA
  • NPI 1083879084
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1396279105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24123 DEL MONTE DR UNIT 95",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553819",
            "telephone_number": "818-477-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24123 DEL MONTE DR UNIT 95",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553819",
            "telephone_number": "818-477-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTIRAK CHAIWONGKARJOHN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "CHAIWONGKARJOHN",
        "authorized_official_first_name": "SUTTIRAK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-477-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A115809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A115809",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Valencia, CA
• Providers in Valencia, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.