Individual
DIMITRI SIRAKOFF
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1206 E 17TH ST, STE 204, SANTA ANA, CA 92701-2641
(714) 835-3500
(714) 835-4619
Mailing address
1206 E 17TH ST, STE 204, SANTA ANA, CA 92701-2641
(714) 835-3500
(714) 835-4619
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A5552
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX55521
—
CA
01
—
0SD0899486
CLIA ID
CA
Enumeration date
06/17/2006
Last updated
03/07/2023
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