MEDICARE: NAPATT KANJANAHATTAKIJ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	MT211691	PA
2	207RI0011X	Interventional Cardiology Physician	22816	NV

General Provider Information

NPI Number	:	1871943183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAPATT KANJANAHATTAKIJ

Provider Business Mailing Address
First Line	:	645 N ARLINGTON AVE STE 555
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89503-4452
Country	:	US
Telephone Number	:	775-770-7622
Fax Number	:

Provider Business Practice Location Address
First Line	:	645 N ARLINGTON AVE STE 555
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89503-4452
Country	:	US
Telephone Number	:	775-770-7622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	02/09/2023

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