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General NPI Number Information
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NPI Number | 1750675286
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Entity Type | Organization
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Legal Business Name | R SANKARAM M D A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 11100 WARNER AVE SUITE 260
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7506
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Country | US
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Telephone | 714-641-6900
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Fax | 714-641-3900
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Provider Business Mailing Address
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Address Line | 62 MODENA
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City | IRVINE
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State | CA
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Zip | 92618-0104
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Country | US
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Telephone | 714-721-0848
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Fax | 949-387-2500
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Authorized Official
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Title or Position | ADMINISTRATION MANAGER
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Name | CELINE DUONG
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Credential |
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Telephone | 714-721-0848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | A25687
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License Number State | CA
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