Healthcare Provider Details

I. General information

NPI: 1790710234
Provider Name (Legal Business Name): SURINDER K. DARGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1439 E CHAPMAN AVE
ORANGE CA
92866-2228
US

IV. Provider business mailing address

486 N CHANDLER RANCH RD
ORANGE CA
92869-4504
US

V. Phone/Fax

Practice location:
  • Phone: 714-633-7770
  • Fax: 714-289-0639
Mailing address:
  • Phone: 714-633-3214
  • Fax: 714-289-0639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA32843
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: