Provider Demographics
NPI:1598053027
Name:CHARASCHIRAKUL, ARNOLD (MBA, ATC)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:CHARASCHIRAKUL
Suffix:
Gender:M
Credentials:MBA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 ACTRIZ PL
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-1459
Mailing Address - Country:US
Mailing Address - Phone:805-304-2668
Mailing Address - Fax:
Practice Address - Street 1:5201 NORRIS CANYON RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583
Practice Address - Country:US
Practice Address - Phone:925-939-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20000075402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer