DR. THIANCHAI BUNNALAI (NPI# 1538242045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538242045 |
| Entity Type | Individual |
| Full Name | DR. THIANCHAI BUNNALAI |
| Credential | MD |
| Practice Address |
2823 Fresno St Fresno CA 93721-1324 |
| Mailing Address |
2625 E Divisadero St Fresno CA 93721-1431 |
| Practice Telephone | 5594996556 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-01-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
C129732 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2823 FRESNO ST |
| City | FRESNO |
| State | CA |
| Zip Code | 93721-1324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073502449 | Catherine C Thaxter | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2005-10-19 |
| 1558973362 | Craig M Peek | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-08-21 |
| 1336759513 | James M Nguyen | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-08-03 |
| 1205445715 | Mckinsey Holthaus | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-07-30 |
| 1285257063 | Blake Phillip Dreihaus | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-05-27 |
| 1639792831 | Surpreme Health | Internal Medicine | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-05-21 |
| 1588286439 | Haylee Degrood | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-05-14 |
| 1710509013 | Katherine Marie Pate | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-05-11 |
| 1154941011 | Kylie Wermund | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-04-21 |
| 1326674292 | Amritpal Singh Padda | Nurse Practitioner | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-03-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487297107 | Fareeha Sipra | Nurse Practitioner | Fresno County Jail, 1225 M Street, Fresno, CA 93721 | 2019-10-25 |
| 1619521929 | Kepler Education Incorporation | Local Education Agency (LEA) | 1462 Broadway St., Fresno, CA 93721 | 2019-07-25 |
| 1588156434 | Micha Ramirez | Case Manager/Care Coordinator | 2140 Merced St., Fresno, CA 93721 | 2018-06-05 |
| 1649798992 | Nadia C Martinez | Licensed Vocational Nurse | 1310 M. Street, Fresno, CA 93721 | 2017-09-07 |
| 1538604251 | Be Together Home Care LLC | In Home Supportive Care | 2014 Tulare St Ste 605, Fresno, CA 93721 | 2017-01-04 |
| 1124426705 | Central California Faculty Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2554 Merced Street, Fresno, CA 93721 | 2014-12-12 |
| 1427455336 | University Medical Supply | Durable Medical Equipment & Medical Supplies | 2554 Merced St, Fresno, CA 93721 | 2014-11-21 |
| 1154723542 | Ryan Gil | Physical Therapist | 1350 O St Ste 201, Fresno, CA 93721 | 2014-09-17 |
| 1831526250 | Tiffany Marie Gonzalez | Counselor | 2409 Mered St #106, Fresno, CA 93721 | 2013-09-30 |
| 1972939783 | Reshale L Thomas | Psychologist | 2900 Fresno St Ste 108, Fresno, CA 93721 | 2013-09-25 |
| Find all providers in zip 93721 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023367422 | Batool Alsheikh | Pediatrics | 6235 N Fresno St Ste 103, Fresno, CA 93710 | 2012-08-31 |
| 1952436289 | Boaz Ovadia | Pediatrics | 7060 N Recreation Ave, Suite 101, Fresno, CA 93720-8022 | 2007-02-23 |
| 1184719148 | Robert Dimand | Pediatrics | 6235 N Fresno St, Suite # 103, Fresno, CA 93710-5269 | 2006-10-04 |
| 1821183773 | Adam Holmes | Pediatrics | 6235 N Fresno St, Suite # 103, Fresno, CA 93710-5269 | 2006-10-04 |
| 1427143270 | Alicia Herrera | Pediatrics | 6235 N Fresno St, Suite # 103, Fresno, CA 93710-5269 | 2006-10-04 |
| 1134214901 | Harry Kallas | Pediatrics | 6235 N Fresno St, Suite # 103, Fresno, CA 93710-5269 | 2006-10-04 |
| 1639264385 | Jorge Montes | Pediatrics | 290 N Wayte Ln, Fresno, CA 93701-2124 | 2006-10-04 |
| 1053406850 | Samuel Lehman | Pediatrics | 6235 N Fresno St, Suite # 103, Fresno, CA 93710-5269 | 2006-10-04 |
| 1053322784 | Kathleen Marie Murphy | Pediatrics | 6235 N Fresno St, Suite # 103, Fresno, CA 93710-5269 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417368804 | Sara Aghamohammadi | Pediatrics | 4650 W Sunset Blvd # Ms 3, Los Angeles, CA 90027-6062 | 2014-05-19 |
| 1699093880 | Richard P Lion | Pediatrics | 11234 Anderson St Rm 5763, Loma Linda, CA 92354-2804 | 2010-05-12 |
| 1558505719 | Ryan Richard Taylor | Pediatrics | Mattel Childrens Hospital At Ucla, 10833 Le Conte Ave., 12-494, Mdcc, Los Angeles, CA 90095-0001 | 2009-04-30 |
| 1871737270 | Shan Lyn Ward | Pediatrics | 3333 California St # S110, San Francisco, CA 94118-1981 | 2009-04-29 |
| 1932341641 | Anas Al Kawass | Pediatrics | 17100 Euclid Street, Picu, Fountain Valley, CA 92708 | 2009-03-26 |
| 1497996649 | Andreas Schwingshackl | Pediatrics | Rrmc 400 Westwood Blvd, Los Angeles, CA 90095-2113 | 2009-03-18 |
| 1588804801 | Carol Elizabeth Nicholson | Pediatrics | 6461 Zuma View Pl, #149, Malibu, CA 90265-4495 | 2009-02-26 |
| 1831355320 | Niveditha Vilasagar | Pediatrics | 4867 W Sunset Blvd Fl 5, Los Angeles, CA 90027-5969 | 2008-08-04 |
| 1154519072 | Eloa S. Adams | Pediatrics | 275 W Macarthu, Oakland, CA 94611-5641 | 2007-10-04 |
| 1770787046 | Samer Yousfi | Pediatrics | 1000 Carson Street, Harbor-ucla Medical Center, Torrance, CA 90509 | 2007-06-12 |
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| 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.