Healthcare Provider Details

I. General information

NPI: 1265220362
Provider Name (Legal Business Name): SARE DEMIREL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARE KILIC

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DRIVE AHSB, SUITE 201
RANCHO MIRAGE CA
92270
US

IV. Provider business mailing address

56 CAMPTON PL
LAGUNA NIGUEL CA
92677-4733
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-3782
  • Fax: 760-837-8581
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: