Jimmy Chanbonpin, M.D.
Individual provider Active NPI Diagnostic Radiology Physician · San Marino, CA
NPI 1699859520 · NPPES record last updated Oct 10, 2016
Key facts
- NPI
- 1699859520
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- A39381 (CA)
- Practice address
- 1654 S El Molino Ave
San Marino, CA 91108-1701 - Phone
- (626) 285-5700
- Fax
- (626) 285-0700
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A39381 | CA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Premier Physicians Inc | Diagnostic Radiology | Current |
Accepting new patients |
| Diagnostic Imaging Med GRP of Kent | Diagnostic Radiology | Current | Accepting new patients |
| Regata Management Inc | Past |
Accepting new patients | |
| RJ Ultrasound, Inc. | Diagnostic Radiology | Past |
Accepting new patients |
Locations
320 S Garfield Ave
Ste 102
Alhambra, CA 91801
Phone (626) 281-0124
2627 W Florida Ave
Ste 208
Hemet, CA 92545
Phone (951) 929-1700
5465 Santa Monica Blvd
Ste 101
Los Angeles, CA 90029
Phone (323) 467-7770
312 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 572-2889
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | A39381 | CA | Yes |
Addresses
Primary practice location
1654 S El Molino Ave
San Marino, CA 91108-1701
Mailing address
1654 S El Molino Ave
San Marino, CA 91108-1701
Phone (626) 285-5700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A39381 | Medicaid | CA | |
| 1699859520 | Medicaid | CA |
Other names
- Dr. Jimmy Chanbonpin
Other providers in San Marino, CA
- Caliber Dermatology, a Medical Corporation
- Linda Yee Chak
- Brian Chan
- Cassie Chan
- Hok Yin Liza Chan
- Diana Chang
- Wayne H Chang
- Daniel Chee
- Sonya Chen-Hsieh
- Chen I Chen
All providers in San Marino, CA · Diagnostic Radiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.