Healthcare Provider Details

I. General information

NPI: 1851758015
Provider Name (Legal Business Name): HUMBERTO SAURI, MD INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N TUSTIN AVE SUITE 109
SANTA ANA CA
92705-6504
US

IV. Provider business mailing address

999 N TUSTTIN AVE SUITE 109
SANTA ANA CA
92705-6504
US

V. Phone/Fax

Practice location:
  • Phone: 714-954-1182
  • Fax: 714-953-3425
Mailing address:
  • Phone: 714-954-1185
  • Fax: 714-953-3425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License NumberG78049
License Number StateCA

VIII. Authorized Official

Name: DR. HUMBERTO SAURI
Title or Position: PRESIDENT
Credential: MD
Phone: 714-354-1182