MEDICARE: KANAT RANSIBRAHMANAKUL M.D.

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	207R00000X	Internal Medicine Physician	A066312	CA

General Provider Information

NPI Number	:	1407831662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KANAT RANSIBRAHMANAKUL M.D.

Provider Business Mailing Address
First Line	:	1580 CREEKSIDE DR STE 220
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-3888
Country	:	US
Telephone Number	:	916-983-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	1580 CREEKSIDE DR STE 220
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-3888
Country	:	US
Telephone Number	:	916-983-4444
Fax Number	:

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

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	03/29/2018

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