Individual provider Active NPI

Arnold Charaschirakul, MBA, ATC

  • Athletic Trainer
  • San Ramon, CA
National Provider Identifier
1598053027
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2000007540 Issued in CA
Practice address
5201 Norris Canyon Rd Ste 300
San Ramon, CA 94583
Phone
(925) 939-8585
NPI assigned
Jul 18, 2011
Last updated
Sep 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2000007540 CA Primary

Addresses

Primary practice location

5201 Norris Canyon Rd Ste 300
San Ramon, CA 94583

Mailing address

4512 Actriz PL
Martinez, CA 94553-1459
Phone (805) 304-2668

Other practice location 1

2619 Tumbleweed Ave
Simi Valley, CA 93065-1309
Phone (805) 304-2668

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
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
2000007540CAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Specialist Surgical Center LLC Current Accepting new patients
Willow Surgery Center, LLC Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1598053027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 ACTRIZ PL",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945531459",
            "telephone_number": "805-304-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 NORRIS CANYON RD STE 300",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "94583",
            "telephone_number": "925-939-8585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2619 Tumbleweed Ave",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930651309",
            "country_code": "US",
            "telephone_number": "805-304-2668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARASCHIRAKUL",
        "first_name": "ARNOLD",
        "credential": "MBA, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-18",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "2000007540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.