Provider Demographics
NPI:1487832101
Name:CHAIKUMNERD, DOLJAI (RN,PHN)
Entity Type:Individual
Prefix:MISS
First Name:DOLJAI
Middle Name:
Last Name:CHAIKUMNERD
Suffix:
Gender:F
Credentials:RN,PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 FERGUSON DR
Mailing Address - Street 2:210-04
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90022-5164
Mailing Address - Country:US
Mailing Address - Phone:323-869-8236
Mailing Address - Fax:
Practice Address - Street 1:5555 FERGUSON DR
Practice Address - Street 2:210-04
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90022-5164
Practice Address - Country:US
Practice Address - Phone:323-869-8236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA383438163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management