Look up the most recent NPI and PECOS records

Tiranun Rungvivatjarus

Pediatrics

Allopathic & Osteopathic Physicians

3020 Childrens Way, San Diego, CA 92123-4223

PECOS Enrollment

Based on the most recent information from CMS, provider Tiranun Rungvivatjarus is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:29 PM.

Profile Details

Provider ID
1407276363
Provider Type
Individual
Full Name
Rungvivatjarus, Tiranun
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
4/18/2014
Last Updated
3/17/2018

Contact Information

Practice Location

3020 Childrens Way, San Diego, CA 92123-4223

(858) 966-5841

Unlisted Fax

Mailing Location

3020 Childrens Way # Mc5064, San Diego, CA 92123-4223

(858) 966-5841

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License A141353 California

Tiranun Rungvivatjarus

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Clark, Patricia Chu

Gillis, Ryan Patrick

Powell, Stephanie J

Lee, Michael Sutherland

Mannino Avila, Elizabeth Ellen

Todd, Sarah Catherine

Chen, Eileen

Bartoletti, Joseph John

Crow, Janet K

Rothman, Joshua Marc