Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A103806 | CA |
NPI | 1033375910 |
---|---|
Provider Name | Dr. Nipaporn Pichetshote |
First Address | Los Angeles, CA 90095-5631 |
Second Address | Beverly Hills, CA 90210-5139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2008 |
Last Update Date | 18/01/2022 |