Healthcare Provider Details

I. General information

NPI: 1093456741
Provider Name (Legal Business Name): NARIN THANAPUTKAIPORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST # AT
LOS ANGELES CA
90089-1001
US

IV. Provider business mailing address

305/110 PICHAI RD.
DUSIT BANGKOK
10300
TH

V. Phone/Fax

Practice location:
  • Phone: 323-226-2622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: