Healthcare Provider Details

I. General information

NPI: 1053780189
Provider Name (Legal Business Name): SALONI KADAKIA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2015
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date: 03/05/2018
Reactivation Date: 05/09/2018

III. Provider practice location address

10941 BLOOMFIELD ST STE A
LOS ALAMITOS CA
90720-6702
US

IV. Provider business mailing address

10941 BLOOMFIELD ST STE A
LOS ALAMITOS CA
90720-6702
US

V. Phone/Fax

Practice location:
  • Phone: 562-596-1667
  • Fax:
Mailing address:
  • Phone: 310-944-8030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A16992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: