Provider Demographics
NPI:1033225271
Name:LOPANSRI, CHERAPHAT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERAPHAT
Middle Name:
Last Name:LOPANSRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAT
Other - Middle Name:
Other - Last Name:LO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:223 N GARFIELD AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1700
Mailing Address - Country:US
Mailing Address - Phone:626-573-5005
Mailing Address - Fax:626-573-5601
Practice Address - Street 1:223 N GARFIELD AVE., #306
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754
Practice Address - Country:US
Practice Address - Phone:626-573-5005
Practice Address - Fax:626-573-8650
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33669207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1033225271Medicaid
CA1033225271Medicaid