Provider Demographics
NPI:1912216276
Name:SATHIT B. DULKANCHAINUN, M.D., INC.
Entity Type:Organization
Organization Name:SATHIT B. DULKANCHAINUN, M.D., INC.
Other - Org Name:T.S. DULKANCHAINUN, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SATHIT
Authorized Official - Middle Name:B
Authorized Official - Last Name:DULKANCHAINUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-379-0664
Mailing Address - Street 1:11005 MOUNTAIR AVE
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-1215
Mailing Address - Country:US
Mailing Address - Phone:213-379-0664
Mailing Address - Fax:213-417-4641
Practice Address - Street 1:1245 WILSHIRE BLVD
Practice Address - Street 2:SUITE 408
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4810
Practice Address - Country:US
Practice Address - Phone:213-787-6412
Practice Address - Fax:213-417-4641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62004204F00000X, 208600000X, 2086S0102X, 208D00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty