Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 036135349 | IL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | A68760 | CA |
NPI | 1326071762 |
---|---|
Provider Name | Dr. Monthakan Ratnarathorn |
First Address | Los Angeles, CA 90017-2530 |
Second Address | Los Angeles, CA 90017-2530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 27/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A687600 | (05) | CA |
GR0085690 | (05) | CA |
H97915 | (02) | CA |