| Dimitri Sirakoff Do Inc | |
|
1206 E 17th Street Suite 204 Santa Ana CA 92701-2341 | |
| (714) 835-3500 | |
| (714) 835-4619 |
| Full Name | Dimitri Sirakoff Do Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1206 E 17th Street, Santa Ana, California |
| Authorized Official Name and Position | Dimitri Sirakoff (PRESIDENT) |
| Authorized Official Contact | 7148353500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dimitri Sirakoff Do Inc 1206 E 17th Street Suite 204 Santa Ana CA 92701-2341 Ph: (714) 835-3500 | Dimitri Sirakoff Do Inc 1206 E 17th Street Suite 204 Santa Ana CA 92701-2341 Ph: (714) 835-3500 |
| NPI Number | 1235351768 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235351768 | NPI | - | NPPES |
| 00AX55521 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A5552 (California) | Primary |
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