Mongkolrattanothai, Kanokporn
Mongkolrattanothai, Kanokporn is an individual health care provider with primary practice located at 4650 W Sunset Blvd Mailstop # 51, Los Angeles CA 90027-6062. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mongkolrattanothai, Kanokporn can be contacted via phone (323) 361-8736.Contact Information
Primary practice address
4650 W Sunset Blvd Mailstop # 51
Los Angeles CA 90027-6062
Phone: (323) 361-8736
Fax: (323) 361-1183
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036112843 | Illinois |
Profile Details
| NPI number | 1174592950 |
|---|---|
| LBN Legal business name | Mongkolrattanothai, Kanokporn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2006 |
| Last updated | May 7th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174592950 | NPPES |
| Illinois | Other | 07215036 | BCBS |
| Illinois | MEDICAID | 036112843 | BCBS |
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