Organization
IV REGENERATION ROOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJAI THANKACHEN MD (MEDICAL DIRECTOR)
(949) 324-9300
Entity
Organization
Contact information
Practice address
4533 MACARTHUR BLVD STE A109, NEWPORT BEACH, CA 92660-2059
(949) 216-0117
Mailing address
4533 MACARTHUR BLVD STE A, NEWPORT BEACH, CA 92660-2061
(949) 216-0117
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
Other
Enumeration date
08/11/2023
Last updated
08/25/2023
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