Provider Demographics
NPI:1326071762
Name:RATNARATHORN, MONTHAKAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MONTHAKAN
Middle Name:
Last Name:RATNARATHORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 FRANCISCO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2530
Mailing Address - Country:US
Mailing Address - Phone:310-497-5774
Mailing Address - Fax:301-491-7071
Practice Address - Street 1:814 FRANCISCO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2530
Practice Address - Country:US
Practice Address - Phone:310-497-5774
Practice Address - Fax:301-491-7071
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135349207XP3100X
CAA68760207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A687600Medicaid
CAGR0085690Medicaid
CAH97915Medicare UPIN