# SANDEEP THAKKAR DO A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568150662
- **Authorized official:** LAURIE BOOKER (CREDENTIALING MANAGER)
- **Authorized official phone:** (951) 681-8693

## Contact information

- **Practice address:** 15775 LAGUNA CANYON RD STE 190, IRVINE, CA 92618-7707
- **Practice address phone:** (714) 602-9891
- **Practice address fax:** (714) 912-4181
- **Mailing address:** 15775 LAGUNA CANYON RD STE 190, IRVINE, CA 92618-7707
- **Mailing address phone:** (714) 602-9891
- **Mailing address fax:** (714) 912-4181

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/26/2023
- **Last updated:** 04/01/2026