Healthcare Provider Details

I. General information

NPI: 1023048196
Provider Name (Legal Business Name): MANPREET KAUR SARNA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 ENDEAVOR STE 101
IRVINE CA
92618-3180
US

IV. Provider business mailing address

18 ENDEAVOR STE 101
IRVINE CA
92618-3180
US

V. Phone/Fax

Practice location:
  • Phone: 949-509-9915
  • Fax: 949-509-1116
Mailing address:
  • Phone: 949-509-9915
  • Fax: 949-509-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL8495
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC54529
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: