Healthcare Provider Details

I. General information

NPI: 1467047753
Provider Name (Legal Business Name): ROYALKIDS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 ENDEAVOR STE 203
IRVINE CA
92618-3181
US

IV. Provider business mailing address

18 ENDEAVOR STE 203
IRVINE CA
92618-3181
US

V. Phone/Fax

Practice location:
  • Phone: 949-910-3457
  • Fax:
Mailing address:
  • Phone: 904-235-6611
  • Fax: 855-618-2214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: RITI S DAYAL
Title or Position: OWNER/MD
Credential: MD
Phone: 904-235-6611