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General NPI Number Information
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NPI Number | 1689769051
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Entity Type | Individual
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Provider Name | JOHN PHILIP DISAIA MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1901 COLLEGE AVE
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City | SANTA ANA
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State | CA
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Zip | 92706-2334
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Country | US
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Telephone | 714-564-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 20409 YORBA LINDA BLVD STE K2
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City | YORBA LINDA
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State | CA
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Zip | 92886-3042
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Country | US
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Telephone | 949-285-5969
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | G072451
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License Number State | CA
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