Provider Demographics
NPI:1851908271
Name:CHAND, SUNITA
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:
Last Name:CHAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8472 BEACH CIR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2069
Mailing Address - Country:US
Mailing Address - Phone:714-408-0913
Mailing Address - Fax:
Practice Address - Street 1:9282 BLANCHE AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-3408
Practice Address - Country:US
Practice Address - Phone:714-534-7872
Practice Address - Fax:714-537-3510
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306002636310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility