Nongnuch Kongbandalsuke, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP21753 Issued in CA

Practice address

16323 Clark Avenue #C
Bellflower, CA 90706

Phone

(562) 925-7716

Fax

(562) 867-0665

NPI assigned

Aug 29, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Feliciano Navalta Jr., M.D. a Medical Corporation

  • Medical Specialty Clinic/Center
  • Paramount, CA
  • NPI 1942485313
  NPD

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1730438359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14901 TROJAN CIRCLE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92647",
            "telephone_number": "714-895-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16323 CLARK AVENUE #C",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "90706",
            "telephone_number": "562-925-7716",
            "fax_number": "562-867-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONGBANDALSUKE",
        "first_name": "NONGNUCH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP21753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy A Kline, OD
• Andy Young Ko, DDS
• Koam Pharmacy Inc
• Koam Pharmacy LTC Inc
• Han A. Koh, MD
• Barbara Konishi, OD
• Bon Sun Koo
• Brian S. Korotzer, MD
• Barbara D Kotlik, NP
• Frank Alexander Kraetz, PSYD

• Nurse Practitioner in Bellflower, CA
• Providers in Bellflower, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.