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General NPI Number Information
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NPI Number | 1912216276
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Entity Type | Organization
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Legal Business Name | SATHIT B. DULKANCHAINUN, M.D., INC.
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 1245 WILSHIRE BLVD SUITE 408
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City | LOS ANGELES
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State | CA
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Zip | 90017-4810
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Country | US
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Telephone | 213-787-6412
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Fax | 213-417-4641
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Provider Business Mailing Address
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Address Line | 11005 MOUNTAIR AVE
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City | TUJUNGA
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State | CA
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Zip | 91042-1215
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Country | US
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Telephone | 213-379-0664
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Fax | 213-417-4641
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Authorized Official
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Title or Position | CEO
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Name | SATHIT B. DULKANCHAINUN
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Credential | M.D.
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Telephone | 213-379-0664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | A62004
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | A62004
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A62004
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A62004
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A62004
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License Number State | CA
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