Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 31704 | AZ |
N | 207Q00000X | Family Doctor | A43383 | CA |
N | 208000000X | Pediatrician | 31704 | AZ |
Y | 208000000X | Pediatrician | A43383 | CA |
N | 2080N0001X | Neonatal-Perinatal Doctor | 31704 | AZ |
N | 2080N0001X | Neonatal-Perinatal Doctor | A43383 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | 31704 | AZ |
N | 2080P0203X | Pediatric Critical Care Doctor | A43383 | CA |
N | 2080P0214X | Pediatric Pulmonologist | 31704 | AZ |
N | 2080P0214X | Pediatric Pulmonologist | A43383 | CA |
NPI | 1669560231 |
---|---|
Provider Name | Praful Sarode |
First Address | Santa Ana, CA 92705-3528 |
Second Address | Santa Ana, CA 92705-3528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 13/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A433834 | (05) | CA |
E25107 | (02) | CA |