Organization
SRIDHARA K S IYENGAR M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRIDHARA K S IYENGAR M D (OWNER)
(714) 549-1294
Entity
Organization
Contact information
Practice address
11100 WARNER AVE, STE 320, FOUNTAIN VALLEY, CA 92708-7506
(714) 549-1294
(714) 549-1296
Mailing address
11100 WARNER AVE, STE 320, FOUNTAIN VALLEY, CA 92708-7506
(714) 549-1294
(714) 549-1296
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
C42391
CA
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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