Jutharat J. Pattanachinda, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A34191 Issued in CA

Practice address

2655 1St St
#325
Simi Valley, CA 93065-1547

Phone

(805) 206-2000

NPI assigned

Oct 17, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1720077423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 1ST ST",
            "address_2": "#325",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651547",
            "telephone_number": "805-206-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTANACHINDA",
        "first_name": "JUTHARAT",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A34191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpattanachinda815302@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2655 1st St",
            "address_2": "#325",
            "city": "Simi Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930651547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dulari Ketankumar Patel, PHARMD
• Mahendra Natwerlal Patel, M.D.
• Roshan Patel, RPH
• Thelma Lucila Patnett
• Daniel P Pattanachinda, DDS
• Julia Joyce Patterson
• Pablo Malana Pauig II, OTR/L
• Paul Brandt, D.C.
• Yatzi A Paula, B.S, A.S
• Payam Kashfian, M.D., Inc.

• Pediatrics Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.