Organization
RANCHO CAPISTRANO MEDICAL CLINIC
Active
Other names
DANA POINT FAMILY MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHILPA JAGDISH GAIKWAD M.D. (PRESIDENT)
(949) 240-2555
Entity
Organization
Contact information
Practice address
34052 LA PLZ STE 103, DANA POINT, CA 92629-2571
(949) 240-2555
(949) 240-2121
Mailing address
34052 LA PLZ STE 103, DANA POINT, CA 92629-2571
(949) 240-2555
(949) 240-2121
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ65759Z
BLUE SHIELD PROVIDER NO.
CA
Enumeration date
02/23/2007
Last updated
04/23/2009
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