Provider Demographics
NPI:1922447937
Name:DAYAL, RITI SHARMA (MD)
Entity Type:Individual
Prefix:DR
First Name:RITI
Middle Name:SHARMA
Last Name:DAYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RITI
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 ENDEAVOR STE 203
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3181
Mailing Address - Country:US
Mailing Address - Phone:949-910-1188
Mailing Address - Fax:
Practice Address - Street 1:18 ENDEAVOR STE 203
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3181
Practice Address - Country:US
Practice Address - Phone:949-910-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD449350208000000X
VA0101243100208000000X
CAA138766208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102888391Medicaid
PA325801Medicare PIN