Healthcare Provider Details

I. General information

NPI: 1437456134
Provider Name (Legal Business Name): SAYAN D RAY MD PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2011
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 W LA VETA AVE STE 107A
ORANGE CA
92868-3930
US

IV. Provider business mailing address

845 W LA VETA AVE STE 107A
ORANGE CA
92868-3930
US

V. Phone/Fax

Practice location:
  • Phone: 714-289-7171
  • Fax: 714-289-7177
Mailing address:
  • Phone: 714-289-7171
  • Fax: 714-289-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberA66934
License Number StateCA

VIII. Authorized Official

Name: DR. SAYAN DEB RAY
Title or Position: OWNER
Credential: M.D.
Phone: 714-289-7171