Active NPI
Ratana Penkingcarn
- Ambulatory Care Registered Nurse
- Los Angeles, CA
National Provider Identifier
1609303619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- 320059
- Practice address
- 5850 S Main St
Los Angeles, CA 90003-1215 - Phone
- (323) 897-6024
- Fax
- (323) 232-0764
- NPI assigned
- May 22, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | 320059 | CA | Primary |
Addresses
Primary practice location
5850 S Main St
Los Angeles, CA 90003-1215
Mailing address
5850 S Main St
Los Angeles, CA 90003-1215
Phone (323) 897-6024
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 |
|---|---|---|---|
| 320059 | CA | MD | Ambulatory Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1609303619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5850 S MAIN ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900031215",
"telephone_number": "323-897-6024",
"fax_number": "323-232-0764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5850 S MAIN ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900031215",
"telephone_number": "323-897-6024",
"fax_number": "323-232-0764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENKINGCARN",
"first_name": "RATANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ambulatory Care",
"state": "CA",
"license": "320059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.