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General NPI Number Information
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NPI Number | 1447693841
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Entity Type | Organization
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Legal Business Name | DANSUNANKUL LLC
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Dates
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Enumeration Date | 04/16/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 444 BRUCE ST
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City | YREKA
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State | CA
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Zip | 96097-3450
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Country | US
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Telephone | 530-842-4121
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31928
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City | LAS VEGAS
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State | NV
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Zip | 89173-1928
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Authorized Official
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Title or Position | ACCTS MGR
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Name | LORI LABRECQUE
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Credential |
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Telephone | 702-453-3799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A86648
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License Number State | CA
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