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NPI Code Detail

MEDICARE: SOUTHERN CALIFORNIA ID ASSOCIATES, INC.

MEDICARE: SOUTHERN CALIFORNIA ID ASSOCIATES, INC.
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
1207RI0200XInfectious Disease PhysicianA98169CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A98169OTHERCASTATE LICENSE

General Provider Information

NPI Number : 1912262981
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN CALIFORNIA ID ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 320 SUPERIOR AVE STE 370
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-2795
Country : US
Telephone Number : 949-515-3590
Fax Number : 949-515-3594
Provider Business Practice Location Address
First Line : 320 SUPERIOR AVE STE 370
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-2795
Country : US
Telephone Number : 949-515-3590
Fax Number : 949-515-3594
Authorized Official
Title or Position : PRESIDENT
Name : DR. ANJALI SACHDEV VORA
Credential : M.D.
Telephone Number : 949-515-3590
Provider Enumeration Date : 07/05/2012
Last Update Date : 03/08/2021

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Directions to “SOUTHERN CALIFORNIA ID ASSOCIATES, INC. ” Practice Location

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