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General NPI Number Information
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NPI Number | 1851116586
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Entity Type | Individual
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Provider Name | CHANBRAY GAITHER RN, FNP
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 1477 S MANCHESTER AVE
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City | ANAHEIM
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State | CA
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Zip | 92802-2905
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Country | US
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Telephone | 714-782-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 2475 MOON DUST DR
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City | CHINO HILLS
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State | CA
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Zip | 91709-4330
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Country | US
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Telephone | 909-521-8109
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 95190928
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95033083
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License Number State | CA
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