| Southern California Id Associates, Inc. | |
|
320 Superior Ave Ste 370 Newport Beach CA 92663-2795 | |
| (949) 515-3590 | |
| (949) 515-3594 |
| Full Name | Southern California Id Associates, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 320 Superior Ave Ste 370, Newport Beach, California |
| Authorized Official Name and Position | Anjali Sachdev Vora (PRESIDENT) |
| Authorized Official Contact | 9495153590 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern California Id Associates, Inc. 320 Superior Ave Ste 370 Newport Beach CA 92663-2795 Ph: (949) 515-3590 | Southern California Id Associates, Inc. 320 Superior Ave Ste 370 Newport Beach CA 92663-2795 Ph: (949) 515-3590 |
| NPI Number | 1912262981 |
|---|---|
| Provider Enumeration Date | 07/05/2012 |
| Last Update Date | 03/08/2021 |
| Medicare PECOS PAC ID | 1153578679 |
|---|---|
| Medicare Enrollment ID | O20120905000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912262981 | NPI | - | NPPES |
| A98169 | Other | CA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | A98169 (California) | Primary |
| Provider Name | Anjali Vora |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1326248170 PECOS PAC ID: 2062600356 Enrollment ID: I20101230001009 |
| Provider Name | Thrissawan Sungkapalee |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1205145265 PECOS PAC ID: 8820223514 Enrollment ID: I20180108002853 |
| Provider Name | Joshua Chia-hwa Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750745873 PECOS PAC ID: 0042554099 Enrollment ID: I20181203002550 |
| Provider Name | Vinicius K Klee Lopes |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1033420476 PECOS PAC ID: 3476868662 Enrollment ID: I20210421000488 |
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