Vichen Srisuksate, DAOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

11157 Issued in CA

Practice address

1590 El Camino Real, Ste G
San Bruno, CA 94066-5377

Phone

(925) 286-3733

NPI assigned

Oct 22, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Darby Srisuk Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1790011930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 JAMES CT",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972323",
            "telephone_number": "925-286-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 EL CAMINO REAL, STE G",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940665377",
            "telephone_number": "925-286-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRISUKSATE",
        "first_name": "VICHEN",
        "name_prefix": "Dr.",
        "credential": "DAOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-22",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "11157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARBY",
            "last_name": "SRISUK",
            "prefix": "DR.",
            "credential": "DAOM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Acupuncturist in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; 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.