Dimitri Sirakoff Do Inc | |
1206 E 17th Street Suite 204 Santa Ana CA 92701-2341 | |
(714) 835-3500 | |
(714) 835-4619 |
Full Name | Dimitri Sirakoff Do Inc |
---|---|
Speciality | Family Medicine |
Location | 1206 E 17th Street, Santa Ana, California |
Authorized Official Name and Position | Dimitri Sirakoff (PRESIDENT) |
Authorized Official Contact | 7148353500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Dimitri Sirakoff Do Inc 1206 E 17th Street Suite 204 Santa Ana CA 92701-2341 Ph: (714) 835-3500 | Dimitri Sirakoff Do Inc 1206 E 17th Street Suite 204 Santa Ana CA 92701-2341 Ph: (714) 835-3500 |
NPI Number | 1235351768 |
---|---|
Provider Enumeration Date | 05/03/2007 |
Last Update Date | 03/07/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235351768 | NPI | - | NPPES |
00AX55521 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20A5552 (California) | Primary |
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