Organization
SARAH APOLLO DT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA L SANDERSON (CLINIC MANGER)
(661) 993-8941
Entity
Organization
Contact information
Practice address
22 ODYSSEY STE 155, IRVINE, CA 92618-3194
(714) 202-7909
(866) 242-5109
Mailing address
PO BOX 36, DANA POINT, CA 92629-0036
(714) 202-7909
(866) 242-5109
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
20A6613
CA
261QR0400X
Rehabilitation Clinic/Center
20A6613
CA
Other
Enumeration date
07/13/2017
Last updated
07/28/2017
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