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NPI Code Detail

MEDICARE: KATHERINE CHATUPORNPITAK

MEDICARE: KATHERINE CHATUPORNPITAK
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
1183500000XPharmacist62940CA

General Provider Information

NPI Number : 1548539869
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE CHATUPORNPITAK
Provider Business Mailing Address
First Line : 4968 HARRIMAN AVE
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-4016
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 550 S GRAND AVE
Second Line :
City : GLENDORA
State : CA
Zip : 91741-4211
Country : US
Telephone Number : 626-857-0633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2011
Last Update Date : 12/14/2011

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Directions to “ KATHERINE CHATUPORNPITAK ” Practice Location

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