Provider Demographics
NPI:1982177796
Name:DUNAEV, OLGA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:DUNAEV
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 B ST UNIT 417
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-4715
Mailing Address - Country:US
Mailing Address - Phone:619-508-6806
Mailing Address - Fax:
Practice Address - Street 1:1050 B ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-4705
Practice Address - Country:US
Practice Address - Phone:619-508-6806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95149783163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse