Provider Demographics
NPI:1568503639
Name:THIND, SURINDER S (MD,FACC)
Entity Type:Individual
Prefix:DR
First Name:SURINDER
Middle Name:S
Last Name:THIND
Suffix:
Gender:M
Credentials:MD,FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18111 BROOKHURST ST
Mailing Address - Street 2:SUITE 5100
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6728
Mailing Address - Country:US
Mailing Address - Phone:714-564-2238
Mailing Address - Fax:714-434-8145
Practice Address - Street 1:18111 BROOKHURST ST
Practice Address - Street 2:SUITE 5100
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6728
Practice Address - Country:US
Practice Address - Phone:714-564-2238
Practice Address - Fax:714-434-8145
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32303207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY492984Medicaid
CAA87682Medicare UPIN
CAYYY492984Medicaid