PENSRI SMITHEDAJKUL (NPI# 1528137809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528137809 |
| Entity Type | Individual |
| Full Name | PENSRI SMITHEDAJKUL |
| Practice Address |
2411 N Broadway Los Angeles CA 90031 |
| Mailing Address |
6000 N Figueroa St Los Angeles CA 90042-4232 |
| Practice Telephone | 3239872000 |
| Practice Fax Number | 3239871448 |
| Mailing Telephone | 3232545221 |
| Mailing Fax Number | 3232544618 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-08-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
16190 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NURSE PRACTITIONER | 16190 | 01 |
| Street Address |
2411 N BROADWAY |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336132166 | Teresia Mccollister | Family Medicine | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2005-08-26 |
| 1720552037 | Irma Madrigal Campos | Dietitian, Registered | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2019-01-20 |
| 1881002673 | Ilia Jbankov | Nurse Practitioner | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2014-07-24 |
| 1629411228 | Hugh Bach | Family Medicine | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2013-04-12 |
| 1821304965 | Hassan B Halawi | Pediatrics | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2010-08-26 |
| 1124283478 | Victoria Rachele Rossi-campagna | Optometrist | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2008-07-26 |
| 1548439524 | Diala Faddoul | Pediatrics | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2008-02-25 |
| 1962596072 | Lin-huey Hwang | Pediatrics | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2006-10-03 |
| 1669579942 | Arroyo Vista Family Health Foundation | Clinic/Center | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2006-09-20 |
| 1215920046 | Anh Huu Nguyen | Family Medicine | 2411 N Broadway, Los Angeles, CA 90031-2218 | 2005-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194247031 | James Han | Counselor | 2010 Lincoln Park Ave., Los Angeles, CA 90031 | 2017-07-12 |
| 1457712200 | Arturo Ibarra D.d.s. Inc | Dentist | 2407 North Broadway, Los Angeles, CA 90031 | 2016-03-08 |
| 1083081780 | Blair Evans James | Social Worker | 434 E Avenue 28 Ste 106, Los Angeles, CA 90031 | 2015-08-28 |
| 1538578133 | Si Xu | Acupuncturist | 2415 Pasadena Ave, Los Angeles, CA 90031 | 2014-08-07 |
| 1346583309 | Arlene Mary Juarez | Counselor | 2309 Daly Street, Masa Youth Center, Los Angeles, CA 90031 | 2013-03-28 |
| 1770858250 | Rama Paliwal | Pediatrics | 1025 Daly St, Jchs, Los Angeles, CA 90031 | 2012-03-15 |
| 1033482476 | Eloisa Padilla | Social Worker | 2309 Daly St ., Los Angeles, CA 90031 | 2012-02-15 |
| 1851601975 | Edmond Hwan Kim | Acupuncturist | 330 W. Avenue 26, #328, Los Angeles, CA 90031 | 2010-10-08 |
| 1629209382 | Dante Almendral Md, A Medical Corporation | Ophthalmology | 2425 North Broadway St., Los Angeles, CA 90031 | 2009-07-29 |
| 1003044090 | Sindy K. Ramos | Counselor | 1721 Griffin Ave., Los Angeles, CA 90031 | 2009-06-29 |
| Find all providers in zip 90031 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003640 | Samira Kadri | Nurse Practitioner | 431 S Burnside Ave Apt 3g, Los Angeles, CA 90036-5343 | 2020-11-08 |
| 1528672110 | Christopher Tria Coronel | Nurse Practitioner | 3435 Garden Ave, Los Angeles, CA 90039-1919 | 2020-09-01 |
| 1871119701 | Carina Lizette Guerra | Nurse Practitioner | St. John's Well Child and Family Center, Inc., 808 W. 58th Street, Los Angeles, CA 90037 | 2020-06-16 |
| 1548884216 | En Route Medical Staffing LLC | Nurse Practitioner | 3705 W Pico Blvd Ste 1714, Los Angeles, CA 90019-3451 | 2020-05-29 |
| 1922621432 | Latasha Tracy Warren | Nurse Practitioner | 1720 N Fuller Ave Apt 450, Los Angeles, CA 90046-3076 | 2020-05-19 |
| 1578184966 | Shin Il Kim | Nurse Practitioner | 450 Bauchet St Fl 8, Los Angeles, CA 90012-2907 | 2020-04-27 |
| 1457971160 | Karen Kim-chang | Nurse Practitioner | 450 Bauchet St Rm E815, Los Angeles, CA 90012-2907 | 2020-04-22 |
| 1912534033 | Anthony Felipe Banuelos Villa | Nurse Practitioner | 3437 Ellison St, Los Angeles, CA 90063-1901 | 2020-03-26 |
| 1629605506 | Ana Yely Nunez Nunez | Nurse Practitioner | 6017 Miramonte Blvd, Los Angeles, CA 90001-1327 | 2020-03-23 |
| 1154957769 | Maybel Deguzman Dumlao | Nurse Practitioner | 4371 Stewart Ave, Los Angeles, CA 90066-6133 | 2020-03-14 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90031 |
Please comment or provide details below to improve the information on PENSRI SMITHEDAJKUL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.