Pumipak Tantamjarik, MD, FAAFP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A71362 Issued in CA

Practice address

1610 W Edinger Ave Ste B
Santa Ana, CA 92704-4339

Phone

(714) 641-1610

Fax

(714) 641-1146

NPI assigned

Sep 8, 2005

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: arpawong@direct.practicefusion.com

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.

• P K a Medical Corporation

  • Primary Care Clinic/Center
  • Santa Ana, CA
  • NPI 1851537708
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  NPD (past)
• South Coast Global Medical Center, Inc

  • General Acute Care Hospital
  • Santa Ana, CA
  • NPI 1558354258
  NPD (past)
• St. Joseph Hospital

  • Specialist
  • Bethpage, NY
  • NPI 1881799153
  NPD (past)

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1891789566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 W EDINGER AVE STE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927044339",
            "telephone_number": "714-641-1610",
            "fax_number": "714-641-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 W EDINGER AVE STE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927044339",
            "telephone_number": "714-641-1610",
            "fax_number": "714-641-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANTAMJARIK",
        "first_name": "PUMIPAK",
        "name_prefix": "Dr.",
        "credential": "MD, FAAFP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2023-03-07",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A71362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arpawong@direct.practicefusion.com",
            "affiliation": "N",
            "address_1": "1610 W Edinger Ave Ste B",
            "city": "Santa Ana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927044339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nhiep Tang, MD
• Editha Tanig-Sanjongco, FNP-BC
• Kahelelani Yuk Lin Tanouye
• Camille Tanquilut, M.D.
• Tantam Medical Group, Inc.
• Srivimol Tantamjarik, M.D., F.A.A.P.
• Lauren Tantillo, CADC-III, B.S.
• Tanya V Martinez Chiropractic Inc
• Ted Leslie Tanzer, M.D.
• Eunice Tapia Diaz, RN

• Family Medicine Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.