Provider Demographics
NPI:1760875835
Name:DINDOT MEDICAL SERVICES
Entity Type:Organization
Organization Name:DINDOT MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DINDOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-556-3304
Mailing Address - Street 1:2100 MAIN ST STE 1640
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6237
Mailing Address - Country:US
Mailing Address - Phone:949-566-8414
Mailing Address - Fax:949-872-2370
Practice Address - Street 1:26671 ALISO CREEK RD
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4809
Practice Address - Country:US
Practice Address - Phone:949-556-3304
Practice Address - Fax:949-625-5289
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERSONAL CARE PHYSICIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care