Organization
SANO MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOLORES STIRBL (ADMINISTRATOR)
(949) 355-1715
Entity
Organization
Contact information
Practice address
700 W 19TH ST, COSTA MESA, CA 92627-3517
(949) 355-1715
Mailing address
700 W 19TH ST, COSTA MESA, CA 92627-3517
(949) 355-1715
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A30481
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A304810
—
CA
Enumeration date
12/03/2014
Last updated
09/01/2020
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