Individual provider Active NPI

Suluck Chaturabul

  • Pharmacist
  • Fontana, CA
National Provider Identifier
1760850358
Registry record updated Sep 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
73385 Issued in CA
Practice address
17284 Slover Ave
Suite 204
Fontana, CA 92337-7584
Phone
(909) 609-3326
Fax
(909) 609-3325
NPI assigned
Sep 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 73385 CA Primary

Addresses

Primary practice location

17284 Slover Ave
Suite 204
Fontana, CA 92337-7584

Mailing address

403 Vista del Norte
Walnut, CA 91789-1634
Phone (909) 374-1173

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

NPI Registry JSON

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

{
    "created_epoch": "1442102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442102400000",
    "number": "1760850358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 VISTA DEL NORTE",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917891634",
            "telephone_number": "909-374-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17284 SLOVER AVE",
            "address_2": "SUITE 204",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923377584",
            "telephone_number": "909-609-3326",
            "fax_number": "909-609-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATURABUL",
        "first_name": "SULUCK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-13",
        "last_updated": "2015-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "73385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2015; 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.