Individual provider Active NPI

Michael Aungkhin, REGISTERED NURSE

  • Psychiatric/Mental Health Registered Nurse
  • Riverside, CA
National Provider Identifier
1497830962
Registry record updated Nov 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
756959 Issued in CA
Practice address
3840 Myers St
2ND FLR.
Riverside, CA 92503-3614
Phone
(951) 358-7718
Fax
(951) 358-7720
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 201773 CA
Psychiatric/Mental Health Registered Nurse 163WP0808X 756959 CA Primary

Addresses

Primary practice location

3840 Myers St
2ND FLR.
Riverside, CA 92503-3614

Mailing address

18502 Stallion Crest Rd
Riverside, CA 92504-9614
Phone (951) 536-0585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
756959CAMDPsychiatric/Mental Health Registered Nurse
201773CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1497830962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18502 STALLION CREST RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925049614",
            "telephone_number": "951-536-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 MYERS ST",
            "address_2": "2ND FLR.",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033614",
            "telephone_number": "951-358-7718",
            "fax_number": "951-358-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUNGKHIN",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "201773",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "756959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.