Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kanokwan Kultan

Individual provider Acute Care Nurse Practitioner · NPI 1063028298

Kanokwan Kultan is a Nurse Practitioner in San Diego, California. Qualified in 2020, 6 years ago. Practices with P H Patel MD Inc, a 4-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2020
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Practice location Address checks out

15850 Babcock St
San Diego, CA 92127-3680
Phone: (858) 344-8536
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 95015361 (CA)

Record details

NPI number1063028298
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 22, 2020
Last updated in NPPESSeptember 22, 2020
Certification dateSeptember 22, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice P H Patel Md Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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