Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G56112 | CA |
N | 111NI0900X | Internist | G56112 | CA |
Y | 207RG0100X | Gastroenterologist | G56112 | CA |
NPI | 1013943331 |
---|---|
Provider Name | Sittiporn Bencharit |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Valencia, CA 91355-3708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 06/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A53086 | (02) | CA |