Organization
DIMITRI SIRAKOFF DO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIMITRI SIRAKOFF DO (PRESIDENT)
(714) 835-3500
Entity
Organization
Contact information
Practice address
1206 E 17TH STREET, SUITE 204, SANTA ANA, CA 92701-2341
(714) 835-3500
(714) 835-4619
Mailing address
1206 E 17TH STREET, SUITE 204, SANTA ANA, CA 92701-2341
(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
Enumeration date
05/03/2007
Last updated
03/07/2023
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