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

Mikey Thanteraphong

Individual provider Nurse Practitioner · NPI 1437795333

Mikey Thanteraphong is a Nurse Practitioner in Simi Valley, California. Qualified in 2016, 10 years ago. Practices with Agoura Hills Urgentocare PC, a 12-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
10
Licensed in
CA
In the registry since
2019
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Practice location Address checks out

2845 Cochran St Ste B
Simi Valley, CA 93065-7905
Phone: (818) 835-7355
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95013063 (CA)

Record details

NPI number1437795333
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 26, 2019
Last updated in NPPESSeptember 25, 2025
Certification dateSeptember 25, 2025
Mailing addressPo Box 336, Agoura Hills, CA 91376-0336

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Agoura Hills Urgentocare Pc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Simi Valley