Andrew Akapob Kaewtavorn

Primary specialty

PharmacistTaxonomy code 183500000X

License

82842 Issued in CA

Practice address

725 Center Dr
San Marcos, CA 92069-3536

Phone

(760) 871-6867

NPI assigned

Aug 31, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1841968385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 N IVY ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920262722",
            "telephone_number": "909-247-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CENTER DR",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920693536",
            "telephone_number": "760-871-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAEWTAVORN",
        "first_name": "ANDREW",
        "middle_name": "AKAPOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "82842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED PHARMACIST",
            "identifier": "82842",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "w01080phmp04@costco.com",
            "affiliation": "N",
            "endpointDescription": "Costco",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "725 Center Dr",
            "city": "San Marcos",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920693536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cristofer Margarito Juan Ramirez
• Alejandro R Juarez
• Cheryl Ann Jucksch, FNP-BC
• Jumpstart Pediatric Physical Therapy P.C.
• William S Kachele Jr., D.M.D
• Vailyn Kahle
• Kaiser Foundation Health Plan Inc
• Kaiser Foundation Health Plan Inc
• Kaiser Foundation Hospitals
• Kaiser Foundation Hospitals

• All providers in San Marcos, CA
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.