Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
NIKOM UDOM MEDICAL CLINIC
Active
Organization
NIKOM UDOM MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIKOM UDOMPHONKUL M.D. (PRESIDENT)
(530) 846-3604
Entity
Organization
Contact information
Practice address
145 SPRUCE ST, GRIDLEY, CA 95948-0947
(530) 846-3604
(530) 846-2108
Mailing address
PO BOX 947, GRIDLEY, CA 95948-0947
(530) 846-3604
(530) 846-2108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A34194
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A341940
—
CA
Enumeration date
04/19/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers