Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0216X | Pediatric Rheumatologist | 01069624 | IN |
Y | 2080P0216X | Pediatric Rheumatologist | A68277 | CA |
NPI | 1467518209 |
---|---|
Provider Name | Dr. Peter Chiraseveenuprapund |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-2736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 14/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201026580 | (05) | IN |