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Organization
MDPD SPECIALISTS
Active
Organization
MDPD SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDEEP THAKKAR D.O. (OWNER)
(949) 341-0307
Entity
Organization
Contact information
Practice address
16305 SAND CANYON AVE, SUITE 220, IRVINE, CA 92618-3782
(949) 341-0307
Mailing address
16305 SAND CANYON AVE, SUITE 220, IRVINE, CA 92618-3782
(949) 341-0307
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20A10840
CA
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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