Individual provider Active NPI

Dumrong Tangchitnob, M.D.

  • Obstetrics & Gynecology Physician
  • West Covina, CA
National Provider Identifier
1487752374
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A42027 Issued in CA
Practice address
1135 S Sunset Ave
Ste.# 102
West Covina, CA 91790-3937
Phone
(626) 338-5377
Fax
(626) 851-8822
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 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
I20090113000776 CA Practitioner - Obstetrics/Gynecology 1254494578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1135 S Sunset Ave
Suite 102
West Covina, CA 91790-3938

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A42027CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Dumrong Tangchitnob MD Inc Obstetrics & Gynecology CurrentSince Nov 1, 1995 Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Locations

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: dumrongtangchitnob@dumrongtan.allscriptsdirect.net
  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1487752374",
    "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": {
        "last_name": "TANGCHITNOB",
        "first_name": "DUMRONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_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 14, 2016; 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.