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General NPI Number Information
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NPI Number | 1598053027
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Entity Type | Individual
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Provider Name | ARNOLD CHARASCHIRAKUL MBA, ATC
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Gender | Male
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 09/25/2018
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Provider Practice Location Address
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Address Line | 5201 NORRIS CANYON RD STE 300
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City | SAN RAMON
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State | CA
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Zip | 94583
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Country | US
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Telephone | 925-939-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 4512 ACTRIZ PL
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City | MARTINEZ
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State | CA
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Zip | 94553-1459
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Country | US
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Telephone | 805-304-2668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000007540
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License Number State | CA
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