Healthcare Provider Details

I. General information

NPI: 1083246623
Provider Name (Legal Business Name): MILINDA CHIDERA ESTRADA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MILINDA CHIDERA AJAWARA PA

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SUPERIOR AVE STE 210
NEWPORT BEACH CA
92663-3640
US

IV. Provider business mailing address

1501 SUPERIOR AVE STE 210
NEWPORT BEACH CA
92663-3640
US

V. Phone/Fax

Practice location:
  • Phone: 949-996-5355
  • Fax:
Mailing address:
  • Phone: 949-996-5355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number57745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: