Dumrong Jirasut, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A41741 Issued in CA

Practice address

75 W March Lane
Suite H
Stockton, CA 95207-5729

Phone

(209) 477-4485

Fax

(209) 477-4487

NPI assigned

Aug 21, 2006

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

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

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932214517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 W MARCH LANE",
            "address_2": "SUITE H",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075729",
            "telephone_number": "209-477-4485",
            "fax_number": "209-477-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 W MARCH LANE",
            "address_2": "SUITE H",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075729",
            "telephone_number": "209-477-4485",
            "fax_number": "209-477-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIRASUT",
        "first_name": "DUMRONG",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A41741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A417410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naomi Jimenez, LMFT 134255
• Rebecca Virginia Jimenez
• Renee Manuia Jimenez
• Ruby Jimenez
• Verenice Jimenez
• JK Supplier LLC
• Jla Transportation
• Seungbin Jo, ATC
• Brenna Joe
• Victoria K Joe, OTR/L

• General Practice Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.