Active NPI
Pholphat Inpirom
- Radiography Radiologic Technologist
- San Diego, CA
National Provider Identifier
1568701209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiography Radiologic Technologist
- License
- 504629
- Practice address
- 3549 Castle Glen Dr Unit 128
San Diego, CA 92123-2432 - Phone
- (619) 955-2360
- NPI assigned
- Jan 31, 2013
- Last updated
- Jan 31, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Radiography Radiologic Technologist | 2471C3402X | 504629 | CA | Primary |
Addresses
Primary practice location
3549 Castle Glen Dr Unit 128
San Diego, CA 92123-2432
Mailing address
3549 Castle Glen Dr Unit 128
San Diego, CA 92123-2432
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
| License | State | Type | Specialty |
|---|---|---|---|
| 504629 | CA | MD | Radiography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1568701209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3549 CASTLE GLEN DR UNIT 128",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3549 CASTLE GLEN DR UNIT 128",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921232432",
"telephone_number": "619-955-2360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INPIROM",
"first_name": "PHOLPHAT",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-31",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": "CA",
"license": "504629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.