Active NPI
Chanatip Suksang, M.D.
- Adult Medicine Physician
- Walnut Creek, CA
National Provider Identifier
1497977102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- A67844
- Practice address
- 1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501 - Phone
- (925) 939-1220
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | A67844 | CA | Primary |
Addresses
Primary practice location
1220 Rossmoor Pkwy
Walnut Creek, CA 94595-2501
Mailing address
Dept 34929
P.O. Box 39000
San Francisco, CA 94139-0001
Phone (925) 952-2828
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A67844 | CA | MD | Adult Medicine Physician |
| 67844 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394668800000",
"number": "1497977102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT 34929",
"address_2": "P.O. BOX 39000",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941390001",
"telephone_number": "925-952-2828",
"fax_number": "925-952-2850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 ROSSMOOR PKWY",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945952501",
"telephone_number": "925-939-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUKSANG",
"first_name": "CHANATIP",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2014-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "CA",
"license": "A67844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.