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General NPI Number Information
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NPI Number | 1922352467
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Entity Type | Individual
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Provider Name | REGIANE SOARES DE ANDRADE M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 11190 WARNER AVE STE 115
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4028
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Country | US
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Telephone | 714-210-0140
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Fax |
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Provider Business Mailing Address
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Address Line | 200 S MANCHESTER AVE
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City | ORANGE
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State | CA
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Zip | 92868-3217
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Country | US
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Telephone | 714-456-8888
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | NO. A 121499
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | A121499
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License Number State | CA
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