MEDICARE: DR. PHILIP K DAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	G42288	CA

General Provider Information

NPI Number	:	1063480978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP K DAS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 25033
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92799-5033
Country	:	US
Telephone Number	:	800-883-7243
Fax Number	:	714-347-1082

Provider Business Practice Location Address
First Line	:	1525 SUPERIOR AVE STE 114
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3639
Country	:	US
Telephone Number	:	949-646-6999
Fax Number	:	949-646-9699

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	09/27/2024

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