Provider Demographics
NPI:1023048196
Name:SARNA, MANPREET KAUR (MD)
Entity type:Individual
Prefix:DR
First Name:MANPREET
Middle Name:KAUR
Last Name:SARNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ENDEAVOR STE 101
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3180
Mailing Address - Country:US
Mailing Address - Phone:949-509-9915
Mailing Address - Fax:949-509-1116
Practice Address - Street 1:18 ENDEAVOR STE 101
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3180
Practice Address - Country:US
Practice Address - Phone:949-509-9915
Practice Address - Fax:949-509-1116
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8495208000000X
CAC54529208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164866901Medicaid