Healthcare Provider Details

I. General information

NPI: 1821115080
Provider Name (Legal Business Name): JONATHAN SADAI, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NEWPORT CENTER DR SUITE 202
NEWPORT BEACH CA
92660-7601
US

IV. Provider business mailing address

400 NEWPORT CENTER DR SUITE 202
NEWPORT BEACH CA
92660-7601
US

V. Phone/Fax

Practice location:
  • Phone: 949-760-6990
  • Fax: 949-760-6999
Mailing address:
  • Phone: 949-760-6990
  • Fax: 949-760-6999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN SADAI
Title or Position: OWNER
Credential: M.D.
Phone: 949-760-6990